Active NPI
Ishell Y. Calzada, PH.D.
- Clinical Psychologist
- Gurabo, PR
National Provider Identifier
1407005226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2945
- Practice address
- 149, Veredas
Gurabo, PR 00778-9680 - Phone
- (787) 922-3967
- NPI assigned
- Sep 17, 2008
- 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 | 2945 | PR | Primary |
Addresses
Primary practice location
149, Veredas
Gurabo, PR 00778-9680
Mailing address
149, Veredas
Gurabo, PR 00778-9680
Phone (787) 922-3967
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 |
|---|---|---|---|---|
| I20110322000679 | PR | Practitioner - Clinical Psychologist | 3173706546 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Neomed Center, Inc
Practice addresses (Care Compare)
11 Calle Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-1260
Ctro de Med de Fam
11 C Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-3620
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2945 | PR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neomed Center, Inc | Current | Accepting new patients | |
| Neomed Center, Inc. | Current | Accepting new patients | |
| Neomed Center, Inc | Current | Accepting new patients | |
| New Health Med Group Inc | Clinical | Past | Accepting new patients |
Locations
11 Calle Condado
San Lorenzo, PR 00754
Phone (787) 715-1260
130 Calle Carite
Trujillo Alto, PR 00976
Phone (787) 292-3120
Organizations & group practices 9
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.
-
- Clinical Medical Laboratory
- Gurabo, PR
- NPI 1518286962
-
- Federally Qualified Health Center (FQHC)
- Naguabo, PR
- NPI 1093357337
-
- Federally Qualified Health Center (FQHC)
- San Lorenzo, PR
- NPI 1124222682
-
- Federally Qualified Health Center (FQHC)
- Aguas Buenas, PR
- NPI 1316324072
-
- Federally Qualified Health Center (FQHC)
- Juncos, PR
- NPI 1336519644
-
- Federally Qualified Health Center (FQHC)
- Aguas Buenas, PR
- NPI 1427435189
-
- Federally Qualified Health Center (FQHC)
- Trujillo Alto, PR
- NPI 1801090923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221609600000",
"number": "1407005226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149, VEREDAS",
"city": "GURABO",
"state": "PR",
"postal_code": "007789680",
"telephone_number": "787-922-3967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149, VEREDAS",
"city": "GURABO",
"state": "PR",
"postal_code": "007789680",
"telephone_number": "787-922-3967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALZADA",
"first_name": "ISHELL",
"middle_name": "Y.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-17",
"last_updated": "2008-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "2945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gurabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.