Individual provider Active NPI

Richelys Tejero, PSYD

  • Clinical Psychologist
  • Coto Laurel, PR
National Provider Identifier
1487464111
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8299 Issued in PR
Practice address
3020 Ave San Cristobal
Coto Laurel, PR 00780-2896
Phone
(939) 905-2910
NPI assigned
Jan 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 8299 PR Primary

Addresses

Primary practice location

3020 Ave San Cristobal
Coto Laurel, PR 00780-2896

Mailing address

3864 Valle Costero Calle Algas
Santa Isabel, PR 00757
Phone (939) 905-2910

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
I20250206003272 PR Practitioner - Clinical Psychologist 7618407503 Practice locations: Coto Laurel, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Clinicos Interdisciplinarios LLC Clinical CurrentSince Jan 19, 2025 Accepting new patients

Locations

3020 Ave San Cristobal
Ponce, PR 00780
Phone (787) 567-7865

Organizations & group practices 1

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": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1487464111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3864 VALLE COSTERO CALLE ALGAS",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "00757",
            "telephone_number": "939-905-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 AVE SAN CRISTOBAL",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802896",
            "telephone_number": "939-905-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJERO",
        "first_name": "RICHELYS",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "8299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coto Laurel, PR

Sources for this page

Verify at the official NPI Registry.