Individual provider Active NPI

Angel Rondon Roman

  • Psychologist
  • Gurabo, PR
National Provider Identifier
1750425427
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1747 Issued in PR
Practice address
Carretera 941
Salida Barrio Jaguas
Gurabo, PR 00778
Phone
(787) 737-5033
Fax
(787) 737-0244
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1747 PR Primary

Addresses

Primary practice location

Carretera 941
Salida Barrio Jaguas
Gurabo, PR 00778

Mailing address

82 Calle Gardenia
Urb Ciudad Jardin
Carolina, PR 00987-2206
Phone (787) 737-5033

Other identifiers 1

IdentifierTypeStateIssuer
1747OtherPRLICENCIA PSICOLOGO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000237 PR Practitioner - Clinical Psychologist 8921178120 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1747PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. CurrentSince May 16, 2014 Accepting new patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. Current Accepting new patients
Mental Wellness Professional Group, P.S.C. Past Accepting new patients

Locations

46 Calle Morse
Arroyo, PR 00714

Organizations & group practices 3

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750425427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CALLE GARDENIA",
            "address_2": "URB CIUDAD JARDIN",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009872206",
            "telephone_number": "787-737-5033",
            "fax_number": "787-737-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 941",
            "address_2": "SALIDA BARRIO JAGUAS",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-737-5033",
            "fax_number": "787-737-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDON ROMAN",
        "first_name": "ANGEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA PSICOLOGO",
            "identifier": "1747",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.