Individual provider Active NPI

Yiddish Marie Alvarez-Melendez, M. A., PH.D. (C)

  • Psychologist
  • Ponce, PR
National Provider Identifier
1891889663
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2714 Issued in PR
Practice address
#22 Calle Sol
Suite 1
Ponce, PR 00730
Phone
(787) 677-6065
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NA
Psychologist 103T00000X 2714 PR Primary

Addresses

Primary practice location

#22 Calle Sol
Suite 1
Ponce, PR 00730

Mailing address

#22 Calle Sol
Suite 1
Ponce, PR 00730
Phone (787) 677-6065

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
I20131114000571 PR Practitioner - Clinical Psychologist 1153557426 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2714PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios Psicologicos Resurgir, P.S.C. CurrentSince Jun 28, 2015 Accepting new patients

Locations

22 Calle Sol
Ste 1
Ponce, PR 00730
Phone (787) 215-6571

22 Calle Sol
#205
Ponce, PR 00730
Phone (787) 677-6065

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1891889663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#22 CALLE SOL",
            "address_2": "SUITE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-677-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#22 CALLE SOL",
            "address_2": "SUITE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-677-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ-MELENDEZ",
        "first_name": "YIDDISH",
        "middle_name": "MARIE",
        "credential": "M. A., PH.D. (C)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-04-30",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NA",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "2714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.