Individual provider Active NPI

Melissa Cardona, LCDA.

  • Social Worker
  • PR, PR
National Provider Identifier
1609374347
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9809 Issued in PR
Practice address
107 Calle Mar Baltico Urb. Brisas del Mar
Isabela
PR, PR 00662
Phone
(787) 669-3454
Fax
(787) 896-3947
NPI assigned
Jan 29, 2018
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9809 PR Primary

Addresses

Primary practice location

107 Calle Mar Baltico Urb. Brisas del Mar
Isabela
PR, PR 00662

Mailing address

HC 7 Box 75900
San Sebastian, PR 00685-7322
Phone (787) 669-3454

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
I20210330002471 PR Practitioner - Clinical Social Worker 4183031610 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

445 Gonzalez Clemente Ave
Ofic 211D
Mayaguez, PR 00680-1136
Phone (787) 669-3454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9809PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Care,LLC CurrentSince Dec 23, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: melissa.cardonaviera.p1@direct.vitacare.nextgenshare.com

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1609374347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 7 BOX 75900",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006857322",
            "telephone_number": "787-669-3454",
            "fax_number": "787-893-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CALLE MAR BALTICO URB. BRISAS DEL MAR",
            "address_2": "ISABELA",
            "city": "PR",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-669-3454",
            "fax_number": "787-896-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "MELISSA",
        "credential": "LCDA.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PR",
            "license": "9809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in PR, PR

Sources for this page

Verify at the official NPI Registry.