Active NPI
Michelle Burgos Fittipaldi
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1619028784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1983
- Practice address
- Carpinteros #69 Montehiedra
San Juan, PR 00926 - Phone
- (787) 637-4747
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1983 | PR | Primary |
Addresses
Primary practice location
Carpinteros #69 Montehiedra
San Juan, PR 00926
Mailing address
Carpinteros #69 Montehiedra
San Juan, PR 00926
Phone (787) 637-4747
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041029000551 | PR | Practitioner - Clinical Psychologist | 0446212781 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1983 | PR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspira Behavioral Care Corp. | Current | Accepting new patients | |
| Inspira Behavioral Care Corp | Current | Accepting new patients | |
| Inspira Behavioral Care Corp. | Current | Accepting new patients | |
| Aps Clinics of Puerto Rico, Inc. | Past | Accepting new patients | |
| New Health Med Group Inc | Clinical | Past | Accepting new patients |
| Hector J Guerra | Clinical | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Clinic/Center
- Ponce, PR
- NPI 1548084635
-
- Adult Mental Health Clinic/Center
- Carolina, PR
- NPI 1760983399
-
- Adult Mental Health Clinic/Center
- San Juan, PR
- NPI 1336194448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619028784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CARPINTEROS #69 MONTEHIEDRA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-637-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARPINTEROS #69 MONTEHIEDRA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-637-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGOS FITTIPALDI",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "1983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.