Individual provider Active NPI

Michael A Quinones, PHD

  • Clinical Psychologist
  • Plantation, FL
National Provider Identifier
1538758255
Registry record updated Jan 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY11002 Issued in FL
Practice address
7501 NW 4TH St Ste 215
Plantation, FL 33317-2238
Phone
(954) 593-6186
NPI assigned
Jan 16, 2021
Last updated
Jan 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2021

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 PY11002 FL Primary

Addresses

Primary practice location

7501 NW 4TH St Ste 215
Plantation, FL 33317-2238

Mailing address

7501 NW 4TH St Ste 215
Plantation, FL 33317-2238
Phone (954) 593-6186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210727001720 FL Practitioner - Clinical Psychologist 5193128254 Practice locations: Plantation, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7501 NW 4TH St
Suite 215
Plantation, FL 33317-2238
Phone (954) 593-6186

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY11002FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
James B Campbell LLC Clinical CurrentSince Jan 24, 2021 Accepting new patients

Locations

7501 NW 4th St
Ste 215
Plantation, FL 33317
Phone (954) 587-0977

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, 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": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1538758255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 NW 4TH ST STE 215",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172238",
            "telephone_number": "954-593-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 NW 4TH ST STE 215",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172238",
            "telephone_number": "954-593-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-16",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.