Individual provider Active NPI

Julio Enrique Santana

  • Psychologist
  • San Juan, PR
National Provider Identifier
1356680151
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
004640 Issued in PR
Practice address
550 Sergio Cuevas Bustamante
CDT Hosptial del Maestro
San Juan, PR 00918
Phone
(787) 758-8383
NPI assigned
Feb 14, 2013
Last updated
Feb 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 004640 PR Primary

Addresses

Primary practice location

550 Sergio Cuevas Bustamante
CDT Hosptial del Maestro
San Juan, PR 00918

Mailing address

774 Calle Polaris
Dos Pino
San Juan, PR 00923-2320
Phone (787) 602-1287

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
I20150127000494 PR Practitioner - Clinical Psychologist 4486978236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004640PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Asociacion de Maestros de P R CurrentSince Dec 3, 2014 Accepting new patients

Locations

158 Calle Ramos Antonini E
Mayaguez, PR 00680
Phone (787) 831-3130

Organizations & group practices 1

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": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1356680151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 CALLE POLARIS",
            "address_2": "DOS PINO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009232320",
            "telephone_number": "787-602-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SERGIO CUEVAS BUSTAMANTE",
            "address_2": "CDT HOSPTIAL DEL MAESTRO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-758-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "JULIO",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "004640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.