Individual provider Active NPI

Abdiel Elias De la Paz Rodriguez, PSY.D

  • Clinical Psychologist
  • Carolina, PR
National Provider Identifier
1376881540
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
004582 Issued in PR
Practice address
Carr. 848 San Anton
Centro Comercial Plaza 66 St 5C
Carolina, PR 00987
Phone
(787) 463-8377
NPI assigned
Jan 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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 004582 PR Primary

Addresses

Primary practice location

Carr. 848 San Anton
Centro Comercial Plaza 66 St 5C
Carolina, PR 00987

Mailing address

Urb. Chalets de la Fuente II,
Calle Monte Casino, Casa #8
Carolina, PR 00987
Phone (787) 463-8377

Other names 1

  • Dr. Abdiel Elias De la Paz Rodriguez Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621001566 PR Practitioner - Psychologist Billing Independently 9335507573 Practice locations: Carolina, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004582PRMDClinical Psychologist
4582PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1376881540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. CHALETS DE LA FUENTE II,",
            "address_2": "CALLE MONTE CASINO, CASA #8",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-463-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 848 SAN ANTON",
            "address_2": "CENTRO COMERCIAL PLAZA 66 ST 5C",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-463-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PAZ RODRIGUEZ",
        "first_name": "ABDIEL",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "004582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABDIEL",
            "last_name": "DE LA PAZ RODRIGUEZ",
            "middle_name": "ELIAS",
            "prefix": "DR.",
            "credential": "PSY.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.