Individual provider Active NPI

Jacqueline Saavedra-Bracero

  • Psychologist
  • Mayaguez, PR
National Provider Identifier
1851491260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2299 Issued in PR
Practice address
Hospital Ramon Emeterio Betances
Mayaguez, PR 00680
Phone
(787) 840-2575
Fax
(787) 840-8391
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2299 PR Primary

Addresses

Primary practice location

Hospital Ramon Emeterio Betances
Mayaguez, PR 00680

Mailing address

PO Box 7004
Ponce, PR 00732-7004
Phone (787) 840-2575

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
I20070126000345 PR Practitioner - Clinical Psychologist 3779584198 Practice locations: Camuy, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Bo Pueblo Plaza Centro Leonardo Avil
Suite 8 Ave Munoz Rivera 48
Camuy, PR 00627-2654
Phone (787) 975-8210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2299PRMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Medical School Foundation Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851491260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7004",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327004",
            "telephone_number": "787-840-2575",
            "fax_number": "787-840-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL RAMON EMETERIO BETANCES",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-840-2575",
            "fax_number": "787-840-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAAVEDRA-BRACERO",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "2299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.