NPIMap

Individual provider Active NPI

Kabhir Josue Gonzalez Maisonave

  • Clinical Psychologist
  • Moca, PR
National Provider Identifier
1730848540
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7166 Issued in PR
Practice address
Street # 125 KM 6.6 Voladoras
Moca, PR 00676
Phone
(939) 579-1345
NPI assigned
Dec 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7166 PR Primary

Addresses

Primary practice location

Street # 125 KM 6.6 Voladoras
Moca, PR 00676

Mailing address

PO Box 2710
Moca, PR 00676-2710
Phone (939) 579-1345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220311000197 PR Practitioner - Clinical Psychologist 3870988785 Reassigns benefits to 1 organization
Practice locations: Moca, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Migrant Health Center Western Region,Inc 47 clinicians

Practice addresses (Care Compare)

Calle San Rafael Numero
222 La Salud
Mayaguez, PR 00680-4676
Phone (787) 834-7255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Migrant Health Center Western Region, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Migrant Health Center Western Region,Inc Single Specialty CurrentSince Jan 1, 2022 Accepting new patients
Migrant Health Center Western Region Inc Past Accepting new patients
Migrant Health Center Western Region, Inc. Past Accepting new patients
Migrant Health Center Western Region, Inc. Past Accepting new patients

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1730848540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006762710",
            "telephone_number": "939-579-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET # 125 KM 6.6 VOLADORAS",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "939-579-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MAISONAVE",
        "first_name": "KABHIR",
        "middle_name": "JOSUE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

Verify at the official NPI Registry.