Active NPI
Cristina Ivelisse Pagan, MSW
- Clinical Social Worker
- Ciales, PR
National Provider Identifier
1497215149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14072
- Practice address
- Carr 149 KM 13
Ciales, PR 00638 - Phone
- (787) 871-0601
- Fax
- (787) 871-3960
- NPI assigned
- Mar 20, 2019
- Last updated
- Mar 20, 2019
- Sex
- Female
- Sole proprietor
- No
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 Social Worker | 1041C0700X | 14072 | PR | Primary |
Addresses
Primary practice location
Carr 149 KM 13
Ciales, PR 00638
Mailing address
PO Box 1427
Ciales, PR 00638-1427
Phone (787) 871-0601
Other practice location 1
Carr. 149 Km 13
Ciales, PR 00638
Phone (787) 871-0601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14072 | Medicaid | PR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | cipagan@prymed.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553040000000",
"number": "1497215149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1427",
"city": "CIALES",
"state": "PR",
"postal_code": "006381427",
"telephone_number": "787-871-0601",
"fax_number": "787-871-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 149 KM 13",
"city": "CIALES",
"state": "PR",
"postal_code": "00638",
"telephone_number": "787-871-0601",
"fax_number": "787-871-3960"
}
],
"practiceLocations": [
{
"address_1": "Carr. 149 Km 13",
"address_purpose": "LOCATION",
"city": "Ciales",
"state": "PR",
"postal_code": "00638",
"country_code": "US",
"telephone_number": "787-871-0601",
"fax_number": "787-871-3960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAGAN",
"first_name": "CRISTINA",
"middle_name": "IVELISSE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-20",
"last_updated": "2019-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "14072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "14072",
"state": "PR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "cipagan@prymed.org",
"affiliation": "N",
"address_1": "Carr. 149 Km 13",
"city": "Ciales",
"state": "PR",
"country_code": "US",
"postal_code": "00638",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ciales, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.