Individual provider Active NPI

Elizanette Soto Collazo, M.D

  • Psychiatry Physician
  • Juana Diaz, PR
National Provider Identifier
1306001284
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
17237 Issued in PR
Practice address
B13 Urb Monclova
Juana Diaz, PR 00795-2214
Phone
(787) 585-7388
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 17237 PR Primary

Addresses

Primary practice location

B13 Urb Monclova
Juana Diaz, PR 00795-2214

Mailing address

2218 Calle Jilguero
Santa Isabel, PR 00757-2581
Phone (787) 585-7388

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080909000109 PR Practitioner - PsychiatryPractitioner - General Practice 4385710730 Reassigns benefits to 1 organization
Practice locations: Guayama, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Novapsych PSC Psychiatry CurrentSince May 28, 2019 Accepting new patients
Novapsych PSC General Practice PastSince Jun 14, 2020 Accepting new patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1306001284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 CALLE JILGUERO",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007572581",
            "telephone_number": "787-585-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B13 URB MONCLOVA",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007952214",
            "telephone_number": "787-585-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO COLLAZO",
        "first_name": "ELIZANETTE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "17237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.