Individual provider Active NPI

Irmarie Cruz Cortes, PSY D

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1508216979
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2638 Issued in PR
Practice address
Urb Glenview GDNS
F2 Calle Estadia
Ponce, PR 00730-1779
Phone
(787) 546-5315
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 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 2638 PR Primary

Addresses

Primary practice location

Urb Glenview GDNS
F2 Calle Estadia
Ponce, PR 00730-1779

Mailing address

Villa Dos Rios
2806 Calle la Plata
Ponce, PR 00730
Phone (787) 546-5315

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
I20190819001404 PR Practitioner - Clinical Psychologist 6507194354 Reassigns benefits to 1 organization
Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2638PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Psicoterapeutica Bienestar LLC Clinical CurrentSince Mar 9, 2025 Accepting new patients
Sociedad de Educacion Y Rehabilitacion Ser de Puerto Rico Inc Clinical Past Accepting new patients

Locations

2984 Ave Emilio Fagot
Ponce, PR 00716
Phone (787) 342-8162

F2 Calle Estadia
Ponce, PR 00730
Phone (787) 546-5315

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1508216979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VILLA DOS RIOS",
            "address_2": "2806 CALLE LA PLATA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-546-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB GLENVIEW GDNS",
            "address_2": "F2 CALLE ESTADIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007301779",
            "telephone_number": "787-546-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ CORTES",
        "first_name": "IRMARIE",
        "name_prefix": "Ms.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.