Active NPI
Gustavo Nieves
- Clinical Psychologist
- Moca, PR
National Provider Identifier
1710879671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 008472
- Practice address
- Carr 110 KM 13.1 Int Urb Estancias Villa Elena Bo Puebl
Moca, PR 00676 - Phone
- (787) 955-6233
- NPI assigned
- Jul 16, 2025
- Last updated
- Jul 23, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 008472 | PR | Primary |
Addresses
Primary practice location
Carr 110 KM 13.1 Int Urb Estancias Villa Elena Bo Puebl
Moca, PR 00676
Mailing address
545 Calle Gabriel Cardona
Moca, PR 00676-4575
Phone (787) 955-6233
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250904003323 | PR | Practitioner - Clinical Psychologist | 3870095383 | Practice locations: San Sebastian, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Carr 423 KM 0
San Sebastian, PR 00685-9998
Phone (787) 955-6233
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008472 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753228800000",
"number": "1710879671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 CALLE GABRIEL CARDONA",
"city": "MOCA",
"state": "PR",
"postal_code": "006764575",
"telephone_number": "787-955-6233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 110 KM 13.1 INT URB ESTANCIAS VILLA ELENA BO PUEBL",
"city": "MOCA",
"state": "PR",
"postal_code": "00676",
"telephone_number": "787-955-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEVES",
"first_name": "GUSTAVO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-16",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "008472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moca, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.