Individual provider Active NPI

Rossely Roldan Reyes, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Juan, PR
National Provider Identifier
1740483015
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
16992 Issued in PR
Practice address
Ave.Wiston Churchill
287
San Juan, PR 00926
Phone
(787) 760-9638
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16992 PR
Child & Adolescent Psychiatry Physician 2084P0804X 16992 PR Primary
General Practice Physician 208D00000X 16992 PR

Addresses

Primary practice location

Ave.Wiston Churchill
287
San Juan, PR 00926

Mailing address

Calle Quebrada Arenanas Villas del Pilar
B 15
San Juan, PR 00926
Phone (787) 308-2076

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000415 PR Practitioner - Psychiatry 4183758436 Reassigns benefits to 2 organizations
Practice locations: Caguas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16992PRMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc. CurrentSince Mar 19, 2020 Accepting new patients
Inspira Behavioral Care Corp CurrentSince Nov 5, 2022 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Mar 19, 2020 Accepting new patients
Inspira Behavioral Care Corp. Current Accepting new patients
Mennonite General Hospital Inc Current Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Nov 5, 2022 Accepting new patients
Inspira Behavioral Care Corp. General Practice Past Accepting new patients
Instituto Psicoterapeutico de PR General Practice PastSince Nov 5, 2022 Accepting new patients
Centro de Salud Conductual Menonita Cima Past Accepting new patients
Inspira Behavioral Care Corp. General Practice Past Accepting new patients
Aps Clinics of Puerto Rico, Inc. Psychiatry Past Accepting new patients

Locations

15 Calle Hospital
#155
Orocovis, PR 00720
Phone (787) 520-7153

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Organizations & group practices 11

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1740483015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE QUEBRADA ARENANAS VILLAS DEL PILAR",
            "address_2": "B 15",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-308-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE.WISTON CHURCHILL",
            "address_2": "287",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-760-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN REYES",
        "first_name": "ROSSELY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "16992",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "16992",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.