Individual provider Active NPI

Raniel M. Verdejo, PH.D.

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1508163940
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3971 Issued in PR
Practice address
184 Calle Guadalupe
Ponce, PR 00730-3561
Phone
(787) 651-2384
NPI assigned
Feb 22, 2011
Last updated
Jun 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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 3971 PR Primary

Addresses

Primary practice location

184 Calle Guadalupe
Ponce, PR 00730-3561

Mailing address

PO Box 9809
Caguas, PR 00726-9809
Phone (787) 651-2384

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
I20141203000354 PR Practitioner - Clinical Psychologist 7719209758 Reassigns benefits to 1 organization
Practice locations: Guaynabo, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Verdejo Behavioral Health Group, P.S.C. Clinical CurrentSince Jan 15, 2014 Accepting new patients
Laboratorio Clinico Plaza Real Inc PastSince Nov 15, 2025 Accepting new patients

Locations

3 Calle Acuarela
Ste A
Guaynabo, PR 00969
Phone (787) 309-8374

44 Calle Carazo
Guaynabo, PR 00969
Phone (787) 718-4755

44 Calle Carazo
Ste 1C
Guaynabo, PR 00969
Phone (787) 710-4530

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1508163940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9809",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007269809",
            "telephone_number": "787-651-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 CALLE GUADALUPE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007303561",
            "telephone_number": "787-651-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDEJO",
        "first_name": "RANIEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.