Individual provider Active NPI

Jose Vidal Ramos, PSY.D.

  • Clinical Psychologist
  • Toa Baja, PR
National Provider Identifier
1669815908
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
005007 Issued in PR
Practice address
610 Ave. Comerio Marginal
Dentro Supermercado Econo Levittown
Toa Baja, PR 00949
Phone
(787) 784-2218
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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 005007 PR Primary

Addresses

Primary practice location

610 Ave. Comerio Marginal
Dentro Supermercado Econo Levittown
Toa Baja, PR 00949

Mailing address

Extension Forest Hills, Madrid L414
Bayamon, PR 00959-5706
Phone (787) 380-9488

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
I20131003000364 PR Practitioner - Clinical Psychologist 7416181532 Reassigns benefits to 1 organization
Practice locations: Toa Baja, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005007PRMDClinical Psychologist
5007PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
JC Fast Clinic LLC Clinical CurrentSince Jan 1, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1669815908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXTENSION FOREST HILLS, MADRID L414",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595706",
            "telephone_number": "787-380-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 AVE. COMERIO MARGINAL",
            "address_2": "DENTRO SUPERMERCADO ECONO LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-784-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "JOSE",
        "middle_name": "VIDAL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "005007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

Verify at the official NPI Registry.