Active NPI
Roberto Irizarry, PSYD
- Clinical Psychologist
- Humacao, PR
National Provider Identifier
1942569413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3887
- Practice address
- Calle Cruz Ortiz Stella 126
Humacao, PR 00721 - Phone
- (787) 649-6773
- NPI assigned
- May 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3887 | PR | Primary |
Addresses
Primary practice location
Calle Cruz Ortiz Stella 126
Humacao, PR 00721
Mailing address
PO Box 1225
Coamo, PR 00769-1225
Phone (787) 649-6773
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130122000424 | PR | Practitioner - Clinical Psychologist | 0547413734 | Practice locations: Coamo, PR; Guayama, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3887 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1942569413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1225",
"city": "COAMO",
"state": "PR",
"postal_code": "007691225",
"telephone_number": "787-649-6773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE CRUZ ORTIZ STELLA 126",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00721",
"telephone_number": "787-649-6773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRIZARRY",
"first_name": "ROBERTO",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-03",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
- Integrated Emegency Medical Services & Management
- Intelliheart Medical Service LLC
- Intermed East LLC
- Ivelisse Irizarry, M.D.
- Katiria Irizarry
- Wanda I Irizarry, MS SOCIAL WORK
- Irs Holistic Center Bienestar Salud Y Autonomia
- Irs Holistic Center L.L.C
- Island Ortho Specialists LLC
- Jipsi Marie Jaime Morales
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.