Rafael Mora de Jesus, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

001877 Issued in CT

Practice address

210 Wethersfield Ave
Hartford, CT 06114-1113

Phone

(860) 296-0094

Fax

(860) 206-1184

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Rafael Mora Other name

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Psychological Services LLCGroup PAC ID 6406178961, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Hartford Psychological Services, LLC

  • Psychologist
  • Hartford, CT
  • NPI 1891989026
  Medicare reassignment Care Compare group NPD Authorized official
• Hartford Psychological Services LLC.

  • Clinical Psychologist
  • Hartford, CT
  • NPI 1649493115
  NPD Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1366503906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WETHERSFIELD AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141113",
            "telephone_number": "860-296-0094",
            "fax_number": "860-206-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WETHERSFIELD AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141113",
            "telephone_number": "860-296-0094",
            "fax_number": "860-206-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA DE JESUS",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "001877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004132700",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFAEL",
            "last_name": "MORA",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steven D Moore, PHD
• Victoria Moore
• Jeffrey Louis Moorman, M.D.
• Douglas J. Moote, M.D.
• Kally Moquete-Gonzalez, MSW
• Sara Moradi
• Jose Morales-Marin, PA
• Arturo E. Morales, MD
• Deisy Morales
• Jose D Morales

• Psychologist in Hartford, CT
• Providers in Hartford, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.