Active NPI
Rebeca M Campo Malpica, PHD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1992050835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4243
- Practice address
- 29, Ashford & Washington St.
Ashford Medical Center, Suite #300
San Juan, PR 00907-1503 - Phone
- (787) 391-2910
- NPI assigned
- Jul 17, 2012
- Sex
- Female
- 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 | 4243 | PR | Primary |
Addresses
Primary practice location
29, Ashford & Washington St.
Ashford Medical Center, Suite #300
San Juan, PR 00907-1503
Mailing address
RR 36 #1311 El Capa
San Juan, PR 00926
Phone (787) 283-6752
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 |
|---|---|---|---|---|
| I20121022000602 | PR | Practitioner - Clinical Psychologist | 3870743131 | Practice locations: San Juan, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
29 Calle Washington
San Juan, PR 00907-1509
Phone (787) 391-2910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4243 | PR | MD | Neurology with Special Qualifications in Child Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1992050835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 36 #1311 EL CAPA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-283-6752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29, ASHFORD & WASHINGTON ST.",
"address_2": "ASHFORD MEDICAL CENTER, SUITE #300",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009071503",
"telephone_number": "787-391-2910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPO MALPICA",
"first_name": "REBECA",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "4243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.