Selysmarie Martinez Gonzalez, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Aguadilla, Puerto Rico. Her current practice location is
Buen Samaritano Medical & Professional Plaza, Suite #5 Primer Piso Ave. Severiano Cuevas #18, Aguadilla, Puerto Rico. You can reach out to her office (for appointments etc.) via phone at
(787) 560-6237.
Selysmarie Martinez Gonzalez is licensed to practice in Puerto Rico (license number 6383) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1700323359.
Healthcare Provider's Profile
| Full Name | Selysmarie Martinez Gonzalez |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | Buen Samaritano Medical & Professional Plaza, Aguadilla, Puerto Rico |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1700323359
- Provider Enumeration Date: 01/20/2017
- Last Update Date: 03/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 0446615249
- Enrollment ID: I20230501001744
Medical Identifiers
Medical identifiers for Selysmarie Martinez Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700323359 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103TA0700X | Psychologist - Adult Development & Aging | 6383 (Puerto Rico) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 6383 (Puerto Rico) | Secondary |
| 103TH0004X | Psychologist - Health | 6383 (Puerto Rico) | Secondary |
| 103TH0100X | Psychologist - Health Service | 6383 (Puerto Rico) | Secondary |
| 103TP2701X | Psychologist - Group Psychotherapy | 6383 (Puerto Rico) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6383 (Puerto Rico) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Selysmarie Martinez Gonzalez allows following entities to bill medicare on her behalf.
| Entity Name | Mente Renovada Centro De Intervencion Clinica Social |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487161808
PECOS PAC ID: 7214285485
Enrollment ID: O20180803001049 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Selysmarie Martinez Gonzalez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Selysmarie Martinez Gonzalez, PSYD
207b Circulo C,
Aguadilla, PR 00603-1246
Ph: () - | Selysmarie Martinez Gonzalez, PSYD
Buen Samaritano Medical & Professional Plaza, Suite #5 Primer Piso Ave. Severiano Cuevas #18,
Aguadilla, PR 00603
Ph: (787) 560-6237 |
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