Individual provider Active NPI

Carolina Michelle Vicens Cardona, MD

  • Psychiatry Physician
  • San Juan, PR
National Provider Identifier
1669091088
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
24121 Issued in PR
Practice address
431 Ave Hostos
San Juan, PR 00918-3014
Phone
(787) 704-0705
NPI assigned
Apr 15, 2020
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 72114 CT
Psychiatry Physician 2084P0800X 24121 PR Primary

Addresses

Primary practice location

431 Ave Hostos
San Juan, PR 00918-3014

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-9093

Other practice location 1

200 Retreat Ave
Hartford, CT 06106-3310
Phone (860) 545-7000

Other practice location 2

10 Calle Segundo Ruiz Belvis
San Juan, PR 00917
Phone (939) 301-9955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, PR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220817003053 CT Practitioner - Psychiatry 5799168175 Reassigns benefits to 2 organizations
I20241011002709 PR Practitioner - Psychiatry 5799168175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24121PRMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Jul 28, 2024 Accepting new patients
Hartford Hospital Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Inspira Behavioral Care Corp CurrentSince Jul 28, 2024 Accepting new patients
Hartford Hospital CurrentSince Aug 1, 2022 Accepting new patients
Inspira Psychiatric Services PSC Past Accepting new patients

Locations

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

431 Ave Hostos
San Juan, PR 00918
Phone 7877539515226

Interoperability endpoints

  • Direct secure messaging: carolina.vicenscardona@xdr.hhchealthdirect.org

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, 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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1669091088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 AVE HOSTOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183014",
            "telephone_number": "787-704-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Retreat Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063310",
            "country_code": "US",
            "telephone_number": "860-545-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Calle Segundo Ruiz Belvis",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00917",
            "country_code": "US",
            "telephone_number": "939-301-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICENS CARDONA",
        "first_name": "CAROLINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "72114",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "24121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.