NPIMap

Organization Active NPI

Santa Cruz Behavioral PSC

  • Geriatric Psychiatry Physician
  • Bayamon, PR
National Provider Identifier
1851625248
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
14745 Issued in PR
Legal business name
SANTA CRUZ BEHAVIORAL PSC
Practice address
73 Santa Cruz Street
Suite 212
Bayamon, PR 00961
Phone
(787) 798-4592
Fax
(787) 798-8236
NPI assigned
Oct 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Authorized official

Name
Dr. William Julio de Jesus Jr., M.D.NPI 1871578997
Title
Medical Director
Phone
(787) 798-4592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X 14745 PR Primary
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X 3032 PR

Addresses

Primary practice location

73 Santa Cruz Street
Suite 212
Bayamon, PR 00961

Mailing address

PO Box 8129
Bayamon, PR 00960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100708000272 PR Part B Supplier - Clinic/Group Practice 4688705619 Receives reassigned benefits from 6 practitioners
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1851625248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8129",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 SANTA CRUZ STREET",
            "address_2": "SUITE 212",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-798-4592",
            "fax_number": "787-798-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CRUZ BEHAVIORAL PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "JULIO DE JESUS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-798-4592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PR",
            "license": "14745",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PR",
            "license": "3032",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.

Verify at the official NPI Registry.