Active NPI
Sergio Guadalupe
- Psychologist
- San Juan, PR
National Provider Identifier
1770051658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8161
- Practice address
- B Cond Jard de San Ignacio Apt 1403
San Juan, PR 00927-7030 - Phone
- (787) 238-0615
- NPI assigned
- Nov 8, 2018
- Last updated
- Feb 19, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8161 | PR | Primary |
Addresses
Primary practice location
B Cond Jard de San Ignacio Apt 1403
San Juan, PR 00927-7030
Mailing address
5623 Paseo Morel Campos
Ponce, PR 00728-2455
Phone (787) 812-2525
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 |
|---|---|---|---|---|
| I20250410000120 | PR | Practitioner - Clinical Psychologist | 6002330214 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiber Health, Public Benefit Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ponce Health Sciences University
- Dentist
- Ponce, PR
- NPI 1013734821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1770051658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5623 PASEO MOREL CAMPOS",
"city": "PONCE",
"state": "PR",
"postal_code": "007282455",
"telephone_number": "787-812-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "B COND JARD DE SAN IGNACIO APT 1403",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009277030",
"telephone_number": "787-238-0615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUADALUPE",
"first_name": "SERGIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-08",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "8161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.