Organization Active NPI

Clinicamente LLC

  • Clinical Psychologist
  • Bayamon, PR
National Provider Identifier
1700574100
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CLINICAMENTE LLC
Practice address
Calle Santa Cruz 68
Suite 606
Bayamon, PR 00961
Phone
(787) 909-5359
NPI assigned
Apr 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Tainari Davila Rodriguez, PHDNPI 1407278450
Title
Employee
Phone
(787) 909-5359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

Calle Santa Cruz 68
Suite 606
Bayamon, PR 00961

Mailing address

PO Box 10282
San Juan, PR 00922-0282
Phone (787) 909-5359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230614001948 PR Part B Supplier - Clinic/Group Practice 3577921121 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

68 Calle Santa Cruz
Ste 606
Bayamon, PR 00961
Phone (787) 909-5359

A17 Calle 4
Bayamon, PR 00961
Phone (787) 909-5359

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1700574100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10282",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009220282",
            "telephone_number": "787-909-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SANTA CRUZ 68",
            "address_2": "SUITE 606",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-909-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAMENTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "DAVILA RODRIGUEZ",
        "authorized_official_first_name": "TAINARI",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "787-909-5359",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.