Individual provider Active NPI

Alfonso Cappa-Melendez, PSYD

  • Clinical Psychologist
  • Pueblo, CO
National Provider Identifier
1649409715
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0004337 Issued in CO
Practice address
1124 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone
(719) 470-0514
Fax
(719) 960-2444
NPI assigned
Jul 9, 2009
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 0004337 CO Primary

Addresses

Primary practice location

1124 Eagleridge Blvd
Pueblo, CO 81008-2103

Mailing address

1124 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone (719) 299-4344

Other identifiers 1

IdentifierTypeStateIssuer
731420MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20171012003242 CO Practitioner - Clinical Psychologist 1759656382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ponce School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1124 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone (719) 299-4344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004337COMDMedical Physician Assistant

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1649409715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 EAGLERIDGE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082103",
            "telephone_number": "719-299-4344",
            "fax_number": "719-960-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 EAGLERIDGE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082103",
            "telephone_number": "719-470-0514",
            "fax_number": "719-960-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPA-MELENDEZ",
        "first_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "0004337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "731420",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.