Individual provider Active NPI

Anabel Carrasquillo Castro, PSY.D

  • Clinical Psychologist
  • Fajardo, PR
National Provider Identifier
1306875901
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2633 Issued in PR
Practice address
55 Calle del Carmen W
Fajardo, PR 00738-4717
Phone
(787) 860-3558
Fax
(787) 860-3330
NPI assigned
Jul 3, 2006
Last updated
Jul 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2633 PR Primary

Addresses

Primary practice location

55 Calle del Carmen W
Fajardo, PR 00738-4717

Mailing address

55 Calle del Carmen W
Fajardo, PR 00738-4717
Phone (787) 860-3558

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
I20061109000464 PR Practitioner - Clinical Psychologist 4789682584 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Centro Comercial Plaza
66 Carr 848 Urb Villa San Anton Suite 5 C
Carolina, PR 00987
Phone (787) 388-2162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2633PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Continuum Mental Care Corp PastSince Jun 16, 2006 Accepting new patients
Continuum Mental Care Corp Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1306875901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CALLE DEL CARMEN W",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007384717",
            "telephone_number": "787-860-3558",
            "fax_number": "787-860-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE DEL CARMEN W",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007384717",
            "telephone_number": "787-860-3558",
            "fax_number": "787-860-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO CASTRO",
        "first_name": "ANABEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.