Individual provider Active NPI

Xavier Soto Ruiz, PHD

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1770219636
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7470 Issued in PR
Practice address
1034 Ave Hostos
Ponce, PR 00716-1115
Phone
(787) 462-5217
NPI assigned
Jul 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7470 PR Primary

Addresses

Primary practice location

1034 Ave Hostos
Ponce, PR 00716-1115

Mailing address

HC 3 Box 15000
Juana Diaz, PR 00795-9522
Phone (787) 462-5217

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
I20220828000042 PR Practitioner - Clinical Psychologist 9335523125 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7470PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. CurrentSince May 20, 2022 Accepting new patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp CurrentSince May 20, 2022 Accepting new patients
Med Centro, Inc. Past Accepting new patients
Inspira Mental Health Management PastSince May 20, 2022 Accepting new patients

Organizations & group practices 5

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1770219636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 15000",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007959522",
            "telephone_number": "787-462-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 AVE HOSTOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007161115",
            "telephone_number": "787-462-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO RUIZ",
        "first_name": "XAVIER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.