Individual provider Active NPI

Mariemyr Ortiz Perez, LCSW

  • Clinical Social Worker
  • San Juan, PR
National Provider Identifier
1689126088
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13063 Issued in PR
Practice address
1215 Ave FD Roosevelt
San Juan, PR 00920-2804
Phone
(787) 662-5245
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13063 PR Primary

Addresses

Primary practice location

1215 Ave FD Roosevelt
San Juan, PR 00920-2804

Mailing address

1215 Ave FD Roosevelt
San Juan, PR 00920-2804
Phone (787) 662-5245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1689126088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 AVE FD ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009202804",
            "telephone_number": "787-662-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 AVE FD ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009202804",
            "telephone_number": "787-662-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ PEREZ",
        "first_name": "MARIEMYR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "13063",
            "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 Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.