Individual provider Active NPI

Ruben Pina, LPC

  • Clinical Psychologist
  • Mission, TX
National Provider Identifier
1497764708
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37384 Issued in TX
Practice address
900 Plaza Dr
Ste 1
Mission, TX 78572
Phone
(956) 600-7123
Fax
(956) 600-7101
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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 37384 TX Primary

Addresses

Primary practice location

900 Plaza Dr
Ste 1
Mission, TX 78572

Mailing address

900 Plaza Dr
Ste 1
Mission, TX 78572-6049
Phone (956) 600-7123

Other identifiers 1

IdentifierTypeStateIssuer
177318601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160909000915 TX Practitioner - Clinical Psychologist 9436445939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Psychological Associates PLLCGroup PAC ID 0648528406, 2 clinicians

Practice addresses (Care Compare)

423 E Griffin Pkwy
Mission, TX 78572-2915
Phone (956) 600-7123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Psychological Associates PLLC Clinical CurrentSince Apr 19, 2018 Accepting new patients
Asap Medical Equipment & Supply Past Accepting new patients

Locations

600 E Griffin Pkwy
#B
Mission, TX 78572
Phone (956) 600-7123

Organizations & group practices 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1497764708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PLAZA DR",
            "address_2": "STE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726049",
            "telephone_number": "956-600-7123",
            "fax_number": "956-600-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PLAZA DR",
            "address_2": "STE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-600-7123",
            "fax_number": "956-600-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINA",
        "first_name": "RUBEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177318601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.