Individual provider Active NPI

Priscille M Joglar Pagan, PSYD

  • Clinical Psychologist
  • Arcadia, FL
National Provider Identifier
1861469140
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2553 Issued in PR
Practice address
725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752
Phone
(863) 494-1242
Fax
(863) 491-0466
NPI assigned
Mar 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 2553 PR Primary

Addresses

Primary practice location

725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752

Mailing address

PO Box 9022917
San Juan, PR 00902-2917
Phone (939) 218-7262

Other practice location 1

Ea4 Calle Rosa De Tejas
Urb La Rosaleda
Toa Baja, PR 00949-4721
Phone (939) 218-7262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210602003288 FL Practitioner - Clinical Psychologist 1850301888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2553PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellbeing LLC Psychologist CurrentSince Jul 1, 2021 Accepting new patients
MCR Health, Inc. CurrentSince Jul 12, 2021 Accepting new patients
MCR Health, Inc. CurrentSince Jul 12, 2021 Accepting new patients
Psychologistic Clinical Past Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

608 N US Highway 1
Fort Pierce, FL 34950
Phone (772) 971-7084

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1141516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1861469140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9022917",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009022917",
            "telephone_number": "939-218-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE BLDG B",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "863-494-1242",
            "fax_number": "863-491-0466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ea4 Calle Rosa De Tejas",
            "address_2": "Urb La Rosaleda",
            "address_purpose": "LOCATION",
            "city": "Toa Baja",
            "state": "PR",
            "postal_code": "009494721",
            "country_code": "US",
            "telephone_number": "939-218-7262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOGLAR PAGAN",
        "first_name": "PRISCILLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-05",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.