Individual provider Active NPI

Marisell Vera-Maldonado

  • Speech-Language Assistant
  • Aguada, PR
National Provider Identifier
1972264836
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
005912-2 Issued in PR
Practice address
Carr 417 KM 2.3 Bo. Malpaso
Aguada, PR 00602
Phone
(939) 235-0543
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 005912-2 PR Primary

Addresses

Primary practice location

Carr 417 KM 2.3 Bo. Malpaso
Aguada, PR 00602

Mailing address

HC 60 Box 15324
Aguada, PR 00602-9273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005912-2PRMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Speech & Development Clinic, LLC. CurrentSince Sep 24, 2023 Accepting new patients
Amigos Speech Therapy Speech-Language Assistant Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1972264836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 60 BOX 15324",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006029273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 417 KM 2.3 BO. MALPASO",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "939-235-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA-MALDONADO",
        "first_name": "MARISELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "PR",
            "license": "005912-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.