Individual provider Active NPI

Ishell Y. Calzada, PH.D.

  • Clinical Psychologist
  • Gurabo, PR
National Provider Identifier
1407005226
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2945 Issued in PR
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

Updated by the provider on Sep 17, 2008

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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, IncGroup PAC ID 1850284100, 66 clinicians

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

LicenseStateTypeSpecialty
2945PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc. CurrentSince Mar 25, 2015 Accepting new patients
Neomed Center, Inc CurrentSince Mar 25, 2015 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.

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

Verify at the official NPI Registry.