Individual provider Active NPI

Jessica Serrano Berdiel, M.ED

  • School Psychologist
  • Ponce, PR
National Provider Identifier
1336442623
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
3956 Issued in PR
Practice address
388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Phone
(787) 812-2525
NPI assigned
Dec 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3956 PR Primary

Addresses

Primary practice location

388 Zona Ind Reparada 2
Ponce, PR 00716-2347

Mailing address

PO Box 510
Adjuntas, PR 00601-0510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230524002047 PR Practitioner - Psychologist Billing Independently 1759747330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
3956PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Tiber Health, Public Benefit Corporation CurrentSince Feb 9, 2023 Accepting new patients
Tiber Health, Public Benefit Corporation CurrentSince Feb 9, 2023 Accepting new patients
Tiber Health, Public Benefit Corporation PastSince Sep 29, 2024 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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1336442623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "006010510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 ZONA IND REPARADA 2",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162347",
            "telephone_number": "787-812-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO BERDIEL",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "3956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.