Individual provider Active NPI

Abdiel Muniz Vera, DR

  • Clinical Psychologist
  • Moca, PR
National Provider Identifier
1376115295
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7030 Issued in PR
Practice address
Carr 125 KM 5.5
Bo Voladoras
Moca, PR 00676
Phone
(787) 546-7508
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7030 PR Primary

Addresses

Primary practice location

Carr 125 KM 5.5
Bo Voladoras
Moca, PR 00676

Mailing address

PO Box 1106
Moca, PR 00676-1106
Phone (787) 546-7508

Other identifiers 1

IdentifierTypeStateIssuer
7875467508OtherCELULAR

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
I20211209003041 PR Practitioner - Clinical Psychologist 8325438112 Reassigns benefits to 1 organization
Practice locations: Moca, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7030PRMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psidep LLC Single Specialty CurrentSince Jun 3, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1376115295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1106",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006761106",
            "telephone_number": "787-546-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 125 KM 5.5",
            "address_2": "BO VOLADORAS",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-546-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ VERA",
        "first_name": "ABDIEL",
        "name_prefix": "Dr.",
        "credential": "DR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CELULAR",
            "identifier": "7875467508",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

Verify at the official NPI Registry.