Individual provider Active NPI

Melissa Flores Roldan, PSY D

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1780892265
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5800 Issued in PR
Practice address
2604 Blvd Luis a Ferre
Ponce, PR 00717-2107
Phone
(787) 844-3077
NPI assigned
May 18, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1780 PR
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 5800 PR Primary

Addresses

Primary practice location

2604 Blvd Luis a Ferre
Ponce, PR 00717-2107

Mailing address

Condominio Estancias del Sur Apt. 401
Ponce, PR 00731
Phone (787) 566-0681

Other practice location 1

Condominio Estancias del Sur Apartamento 401
Ponce, PR 00731
Phone (787) 566-0681

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
I20171012002359 PR Practitioner - Clinical Psychologist 9436424710 Practice locations: Coto Laurel, PR; Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2604 Blvd Luis a Ferre
Ponce, PR 00717-2107
Phone (787) 692-7644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5800PRMDClinical Psychologist
1780PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
N & N Psychological Services Multi-Specialty PastSince Aug 26, 2024 Accepting new patients
Servicios Clinicos Interdisciplinarios LLC Clinical PastSince Apr 9, 2024 Accepting new patients
Centro Holistico Bienestar Mental Multi-Specialty Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780892265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CONDOMINIO ESTANCIAS DEL SUR APT. 401",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-566-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 BLVD LUIS A FERRE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172107",
            "telephone_number": "787-844-3077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Condominio Estancias del Sur Apartamento 401",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "00731",
            "country_code": "US",
            "telephone_number": "787-566-0681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES ROLDAN",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PR",
            "license": "1780",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "5800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.