Individual provider Active NPI

Roberto C Marrero, PH.D

  • Clinical Psychologist
  • Villalba, PR
National Provider Identifier
1881962330
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4140 Issued in PR
Practice address
16 Calle Munoz Rivera
Villalba, PR 00766-2224
Phone
(787) 847-4270
Fax
(787) 847-3057
NPI assigned
Dec 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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 4140 PR Primary

Addresses

Primary practice location

16 Calle Munoz Rivera
Villalba, PR 00766-2224

Mailing address

PO Box 43
Villalba, PR 00766-0043
Phone (787) 847-4270

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
I20120920000583 PR Practitioner - Clinical Psychologist 1850549569 Practice locations: Villalba, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4140PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Dr Marrero LLC Clinical 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": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1881962330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007660043",
            "telephone_number": "787-847-4270",
            "fax_number": "787-847-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CALLE MUNOZ RIVERA",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662224",
            "telephone_number": "787-847-4270",
            "fax_number": "787-847-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "ROBERTO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "4140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

Verify at the official NPI Registry.