Individual provider Active NPI

Maribel Rodriguez, MA

  • Health Service Psychologist
  • Bayamon, PR
National Provider Identifier
1962649673
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
3031 Issued in PR
Practice address
Carretera 167 KM. 15
Villa Chica, Buena Vista
Bayamon, PR 00956
Phone
(787) 319-9492
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 3031 PR Primary

Addresses

Primary practice location

Carretera 167 KM. 15
Villa Chica, Buena Vista
Bayamon, PR 00956

Mailing address

2-46 Calle 44
Royal Town
Bayamon, PR 00956-4515
Phone (787) 319-9492

Other identifiers 1

IdentifierTypeStateIssuer
3031OtherPRPSICOLOGA

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
I20190723001784 PR Practitioner - Clinical Psychologist 1658607031 Practice locations: Trujillo Alto, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3031PRMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Ayuda Psicologica Y de Talleres Educativos Psychologist Past Accepting new patients
Armonia Centro Psicologico Y Educativo Integral, in Past Accepting new patients

Organizations & group practices 2

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1962649673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2-46 CALLE 44",
            "address_2": "ROYAL TOWN",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564515",
            "telephone_number": "787-319-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 167 KM. 15",
            "address_2": "VILLA CHICA, BUENA VISTA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-319-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIBEL",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "PR",
            "license": "3031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSICOLOGA",
            "identifier": "3031",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.