Individual provider Active NPI

Joan Enid Serra Perez, PSY,D

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1497539456
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7753 Issued in PR
Practice address
8118 Calle Concordia Ste 102
Ponce, PR 00717-1589
Phone
(939) 835-7257
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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 7753 PR Primary

Addresses

Primary practice location

8118 Calle Concordia Ste 102
Ponce, PR 00717-1589

Mailing address

HC 06 Box 4769 Coto Laurel
Ponce, PR 00780

Other practice location 1

Ave. Tito Castro, carr. 14 KM 1.1
Ponce, PR 00716
Phone (787) 492-8189

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
I20260205001613 PR Practitioner - Clinical Psychologist 4486133923 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8118 Calle Concordia
Suite 102
Ponce, PR 00717-1589
Phone (939) 835-7257

HC 6 Box
Suite 4769
Coto Laurel, PR 00780-9558

PO Box
Ponce, PR 00732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7753PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Psychological & Consultant Group LLC Clinical CurrentSince Apr 6, 2025 Accepting new patients

Locations

8118 Calle Concordia
Ste 102
Ponce, PR 00717
Phone (787) 844-4600

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1497539456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 06 BOX 4769 COTO LAUREL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 CALLE CONCORDIA STE 102",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "939-835-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ave. Tito Castro, carr. 14 KM 1.1",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "00716",
            "country_code": "US",
            "telephone_number": "787-492-8189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRA PEREZ",
        "first_name": "JOAN",
        "middle_name": "ENID",
        "credential": "PSY,D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.