Individual provider Active NPI

Paola Andrea Munoz, PSY.D., MACJ

  • Clinical Psychologist
  • Smyrna, DE
National Provider Identifier
1336508027
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
B1-0001040 Issued in DE
Practice address
1181 Paddock Rd
Jtvcc - Connections Community Support Programs
Smyrna, DE 19977-9679
Phone
(302) 653-9261
NPI assigned
Feb 23, 2016
Last updated
Feb 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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 B1-0001040 DE Primary

Addresses

Primary practice location

1181 Paddock Rd
Jtvcc - Connections Community Support Programs
Smyrna, DE 19977-9679

Mailing address

434 Seville St # 1
Philadelphia, PA 19128-3630
Phone (301) 219-2718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20200728002283 DE Practitioner - Clinical Psychologist 0648694315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

100 Sunnyside Rd
Smyrna, DE 19977-1752
Phone (302) 653-1900

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc CurrentSince Feb 8, 2021 Accepting new patients
Creative Medical Consulting, LLC CurrentSince Jul 15, 2020 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Feb 8, 2021 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients
Christiana Care Health Services Inc Past Accepting new patients

Locations

100 Sunnyside Rd
#2
Smyrna, DE 19977
Phone (302) 653-1900

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1336508027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 SEVILLE ST # 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283630",
            "telephone_number": "301-219-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 PADDOCK RD",
            "address_2": "JTVCC - CONNECTIONS COMMUNITY SUPPORT PROGRAMS",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199779679",
            "telephone_number": "302-653-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "PAOLA",
        "middle_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MACJ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0001040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

Verify at the official NPI Registry.