Carissa Melendez, M.S
Individual provider Active NPI Psychologist · Toa Baja, PR
NPI 1457796849 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1457796849
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 3333 (PR)
- Practice address
- Carretera 866 KM 1.1 Lote 51 Bo. Candelaria
Toa Baja, PR 00949-0094 - Phone
- (787) 200-8858
- NPI assigned
- Apr 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Foundation of Puerto Rico Inc.
Practice addresses (Care Compare)
Marginal Santa Cruz
17 Urb Santa Cruz
Bayamon, PR 00961-6706
Phone (787) 780-1273
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191008003449 | PR | Practitioner - Clinical Psychologist | 1153652912 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3333 | PR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Foundation of Puerto Rico, Inc. | Current |
Accepting new patients | |
| Community Health Foundation of Puerto Rico, Inc. | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3333 | PR | Yes |
Addresses
Primary practice location
Carretera 866 KM 1.1 Lote 51 Bo. Candelaria
Toa Baja, PR 00949-0094
Mailing address
PO Box 1792
Toa Baja, PR 00951-1792
Phone (787) 200-8858
Other providers in Toa Baja, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.