Individual provider Active NPI

Carmen Lidia Maldonado Trinidad, PSY.D., MAED., MAR,

  • Clinical Psychologist
  • Manati, PR
National Provider Identifier
1568614857
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2666 Issued in PR
Practice address
B16 Calle Marginal
Urb Flamboyan
Manati, PR 00674-5435
Phone
(787) 529-6055
NPI assigned
Oct 17, 2008
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 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 2666 PR Primary

Addresses

Primary practice location

B16 Calle Marginal
Urb Flamboyan
Manati, PR 00674-5435

Mailing address

PO Box 464
Manati, PR 00674-0464
Phone (787) 529-6055

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
I20140305000376 PR Practitioner - Clinical Psychologist 3072743483 Practice locations: Manati, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Urb Flamboyan
B12 Calle Marginal
Manati, PR 00674
Phone (787) 529-6055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2666PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dra Carmen L Maldonado Trinidad Clinical Past Accepting new patients

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1568614857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740464",
            "telephone_number": "787-529-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B16 CALLE MARGINAL",
            "address_2": "URB FLAMBOYAN",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006745435",
            "telephone_number": "787-529-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO TRINIDAD",
        "first_name": "CARMEN",
        "middle_name": "LIDIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MAED., MAR,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.