Individual provider Active NPI

Mirelys Rivera Colon, PSYD

  • Clinical Psychologist
  • Dorado, PR
National Provider Identifier
1508307976
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5857 Issued in PR
Practice address
A1E Calle I
Dorado, PR 00646-2201
Phone
(787) 713-6505
NPI assigned
Mar 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 5857 PR Primary

Addresses

Primary practice location

A1E Calle I
Dorado, PR 00646-2201

Mailing address

HC 74 Box 5988
Naranjito, PR 00719-7421

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
I20220406002176 PR Practitioner - Clinical Psychologist 1456747195 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5857PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc CurrentSince Mar 9, 2022 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 9, 2022 Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 9, 2022 Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 9, 2022 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 9, 2022 Accepting new patients
Salud Integral En la Montana, Inc. Current Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 9, 2022 Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

18 Calle Gerardo Nieves Mercado
Comerio, PR 00782

Organizations & group practices 10

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1508307976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 74 BOX 5988",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "007197421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A1E CALLE I",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006462201",
            "telephone_number": "787-713-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA COLON",
        "first_name": "MIRELYS",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "5857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.