Innovative Psychiatric Group, PSC
Organization Active NPI Psychiatry Physician · Caguas, PR
NPI 1851362735 · NPPES record last updated Mar 4, 2016
Key facts
- NPI
- 1851362735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- INNOVATIVE PSYCHIATRIC GROUP, PSC
- Practice address
- BF4 Calle la Pinta
Urb Bairoa
Caguas, PR 00725 - Phone
- (787) 539-2681
- Fax
- (787) 961-3920
- NPI assigned
- Jan 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Frances Y Marcano
- Title
- Facturadora
- Phone
- (787) 380-1377
Practitioners 3
-
Jonathan Fernandez, PSY.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160601001022 | PR | Part B Supplier - Clinic/Group Practice | 9931499191 |
Receives reassigned benefits from 2 practitioners Practice locations: Caguas, PR |
National Provider Directory
Locations
BF4 Calle La Pinta
Caguas, PR 00725
Phone (787) 539-2681
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
BF4 Calle la Pinta
Urb Bairoa
Caguas, PR 00725
Mailing address
J14 Calle 16
Urb Ciudad Universitaria
Trujillo Alto, PR 00976-3124
Phone (787) 539-2681
Other providers in Caguas, PR
- Infectology Services LLC
- Inmotion Wellness Center Corp
- Innovation Mental Health Services Corp
- Innovative Cardiology Center LLC
- Innovative GYN P.S.C.
- Inpatient Medical Services PR LLC
- Insight Optical
- Insight Optical
- Inspira Behavioral Care Corp.
- Inspira Behavioral Care Corp.
All providers in Caguas, PR · Psychiatry Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.