Individual provider Active NPI

John Joseph Beltran, PSY.D.

  • Clinical Psychologist
  • Kissimmee, FL
National Provider Identifier
1811054109
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7102 Issued in FL
Practice address
3214 Hillsdale LN
Kissimmee, FL 34741-7562
Phone
(407) 518-9161
Fax
(407) 518-9942
NPI assigned
Jan 3, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PY7102 FL Primary

Addresses

Primary practice location

3214 Hillsdale LN
Kissimmee, FL 34741-7562

Mailing address

3214 Hillsdale LN
Kissimmee, FL 34741-7562
Phone (407) 518-9161

Other practice location 1

201 Ruby Ave
suite a
Kissimmee, FL 34741-5697
Phone (407) 518-9161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY7102FLMDClinical Psychologist

Organizations & group practices 2

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811054109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 HILLSDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417562",
            "telephone_number": "407-518-9161",
            "fax_number": "407-518-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 HILLSDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417562",
            "telephone_number": "407-518-9161",
            "fax_number": "407-518-9942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Ruby Ave",
            "address_2": "suite a",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347415697",
            "country_code": "US",
            "telephone_number": "407-518-9161",
            "fax_number": "407-518-9942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.