Individual provider Active NPI

Carmelo Rodriguez-Perez, PSY.D.

  • Clinical Psychologist
  • Vega Baja, PR
National Provider Identifier
1295967222
Registry record updated Aug 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3400 Issued in PR
Practice address
7059 Pisos Reales
Vega Baja, PR 00693-6145
Phone
(787) 604-4020
NPI assigned
Aug 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 000846 PR
Clinical Psychologist 103TC0700X 3400 PR Primary

Addresses

Primary practice location

7059 Pisos Reales
Vega Baja, PR 00693-6145

Mailing address

7059 Pisos Reales
Vega Baja, PR 00693-6145
Phone (787) 604-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215000763 PR Practitioner - Clinical Psychologist 3870773393 Practice locations: Bayamon, PR; Vega Baja, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carretera 2 KL 42 Salida Expreso No
Suite 4
Vega Baja, PR 00693
Phone (787) 608-9957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000846PRMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249689600000",
    "number": "1295967222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7059 PISOS REALES",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006936145",
            "telephone_number": "787-604-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7059 PISOS REALES",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006936145",
            "telephone_number": "787-604-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-PEREZ",
        "first_name": "CARMELO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-08",
        "last_updated": "2009-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PR",
            "license": "000846",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.