Active NPI
Abdiel Elias De la Paz Rodriguez, PSY.D
- Clinical Psychologist
- Carolina, PR
National Provider Identifier
1376881540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 004582
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230621001566 | PR | Practitioner - Psychologist Billing Independently | 9335507573 | Practice locations: Carolina, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004582 | PR | MD | Clinical Psychologist |
| 4582 | PR | MD | Clinical 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.