Amneris Medina Vazquez

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

Carr 111 KM 7.1
Moca, PR 00676

Phone

(939) 630-7208

NPI assigned

Jul 10, 2014

Last updated

Jan 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Medina Vazquez Psychologist LLC

  dba Bright Mind Psychology Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aguada, PR
  • NPI 1518758804
  NPD (past) Authorized official
• Aps Clinics of Puerto Rico, Inc.

  • Adult Mental Health Clinic/Center
  • San Juan, PR
  • NPI 1336194448
  NPD (past)
• Tiber Health, Public Benefit Corporation

  dba Ponce Health Sciences University

  • Multi-Specialty Clinic/Center
  • Ponce, PR
  • NPI 1184139602
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1659787661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006760591",
            "telephone_number": "939-630-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 111 KM 7.1",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "939-630-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA VAZQUEZ",
        "first_name": "AMNERIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "6672",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "4391701",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "FM1213183-02",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MD.SGH.OB/GYN PSC
• Medco Medical Equipment Inc (Medco Pharmacy)
• Nitza Medero, LIC.
• Elsem G Medina Nunez
• Nayrin Z Medina Soto
• Keavette Mejias, MS
• Jorge Luis Mendez Colon, M.D.
• Chinicol Marie Mendez Cordero
• Kimberly Mendez Gonzalez
• Glendaliz Mendez Hernandez, PHARMD

• Counseling Psychologist in Moca, PR
• Providers in Moca, PR by specialty
• Counseling Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.

Verify at the official NPI Registry.