Individual provider Active NPI

Bedynilva Trujillo, PH.D.

  • Clinical Psychologist
  • Gurabo, PR
National Provider Identifier
1902032980
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3171 Issued in PR
Practice address
Calle Andres Aruz Rivera # 200 E Local B - 3
Gurabo, PR 00778-0660
Phone
(787) 737-7979
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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 3171 PR Primary

Addresses

Primary practice location

Calle Andres Aruz Rivera # 200 E Local B - 3
Gurabo, PR 00778-0660

Mailing address

HC 1 Box 11388
Carolina, PR 00987-9638

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
I20190628002248 PR Practitioner - Clinical Psychologist 0648504308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Behavioral Care CorpGroup PAC ID 5294863262, 20 clinicians

Practice addresses (Care Compare)

Carolina Century Business Ctr
Carr 848 Esq 887 Local 23
Carolina, PR 00982-0000
Phone (787) 704-0705

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3171PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current 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": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1902032980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 11388",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009879638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ANDRES ARUZ RIVERA # 200 E LOCAL B - 3",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007780660",
            "telephone_number": "787-737-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "BEDYNILVA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.