Active NPI
Thaiz Rivera
- Clinical Psychologist
- San German, PR
National Provider Identifier
1780006155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5552
- Practice address
- HC 4 Box 13482
San German, PR 00683-9568 - Phone
- (787) 517-9298
- NPI assigned
- Jan 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5552 | PR | Primary |
Addresses
Primary practice location
HC 4 Box 13482
San German, PR 00683-9568
Mailing address
HC 4 Box 13482
San German, PR 00683-9568
Phone (787) 517-9298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151026000923 | PR | Practitioner - Clinical Psychologist | 8729397179 | Practice locations: San German, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud Mental del Oeste | 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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San German, PR
- NPI 1902256456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1780006155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 4 BOX 13482",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006839568",
"telephone_number": "787-517-9298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 4 BOX 13482",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006839568",
"telephone_number": "787-517-9298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "THAIZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-20",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "5552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San German, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.