Active NPI
Carmen M Gomez- Milian, PSY.D.
- Clinical Psychologist
- San Lorenzo, PR
National Provider Identifier
1386976934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3549
- Practice address
- 201 Jose de Diego Ave. Plaza Angora
San Lorenzo, PR 00754 - Phone
- (787) 736-4555
- NPI assigned
- Feb 8, 2010
- Sex
- Female
- 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 | 3549 | PR | Primary |
Addresses
Primary practice location
201 Jose de Diego Ave. Plaza Angora
San Lorenzo, PR 00754
Mailing address
Urb. Mansiones de Monte Sereno
29 Calle 3
San Lorenzo, PR 00754
Phone (787) 398-2868
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180326001746 | PR | Practitioner - Clinical Psychologist | 4082976345 | Practice locations: San Lorenzo, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3549 | PR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1386976934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. MANSIONES DE MONTE SERENO",
"address_2": "29 CALLE 3",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-398-2868",
"fax_number": "787-736-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 JOSE DE DIEGO AVE. PLAZA ANGORA",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-736-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ- MILIAN",
"first_name": "CARMEN",
"middle_name": "M",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-08",
"last_updated": "2022-09-29",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Lorenzo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.