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DR. JAISSELLE MARIE VEGA ROSALY PHD
NPI 1104379320
Psychologist - Cognitive & Behavioral in Ponce, PR

Active since July 25, 2016PECOS EnrolledAccepts Medicare Assignment
775 CALLE CAOBA, CENTRO COMERCIAL LOS CAOBOS, SUITE 6, PONCE, PR 00716(787) 677-0503 Get Directions Write a Review

NPPES record last updated: July 25, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jaisselle Marie Vega Rosaly Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAISSELLE MARIE VEGA ROSALY PHD (NPI 1104379320) is an individual cognitive & behavioral provider in Ponce, Puerto Rico, licensed in Puerto Rico (5738) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1104379320
Entity TypeIndividualFemale
Primary Taxonomy103TB0200X
Provider Legal NameDR. JAISSELLE MARIE VEGA ROSALYCredential: PHD
Location Address775 CALLE CAOBA, CENTRO COMERCIAL LOS CAOBOS, SUITE 6Ponce, PR 00716-2610
Mailing Address775 Calle Caoba, Centro Comercial Los Caobos, Suite 6Ponce, PR 00716-2610 · (787) 677-0503
Phone(787) 677-0503
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJuly 25, 2016
✔ NPI 1104379320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in PR · 5738
Definition
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 5738 (PR)
775 CALLE CAOBA, Ponce, PR 00716
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jaisselle Marie Vega Rosaly Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173896669
PECOS Enrollment IDI20171215002309
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jaisselle Vega Rosaly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mente Activa
Cognitive & Behavioral
775 CALLE CAOBA, CENTRO COMERCIAL LOS CAOBOS, SUITE 10
Ponce, PR 00716
  • Reassigned Medicare billing, Puerto Rico enrollment
  • 2 clinicians in this Medicare group
NPI 1023561230 (787) 677-0503

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MENTE ACTIVA
Psychologist (Cognitive & Behavioral)
775 CALLE CAOBA, CENTRO COMERCIAL LOS CAOBOS, SUITE 10
PONCE, PR 00716
Ponce Municipio (787) 677-0503
DR. MARIA LOURDES CASTELLVI
Dentist (General Practice)
775 CALLE CAOBA, CENTRO COMERCIAL LOS CAOBOS STE. 25
PONCE, PR 00716
Ponce Municipio (787) 841-5111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaisselle Vega Rosaly's NPI number?

The NPI number for Jaisselle Vega Rosaly is 1104379320. It was assigned to this individual provider in the NPPES registry on July 25, 2016.

Where is Jaisselle Vega Rosaly located?

Jaisselle Vega Rosaly practices at 775 Calle Caoba Centro Comercial Los Caobos, Suite 6, Ponce, PR 00716. The listed phone number is (787) 677-0503.

What is Jaisselle Vega Rosaly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Jaisselle Vega Rosaly enrolled in Medicare?

Yes. Jaisselle Vega Rosaly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jaisselle Vega Rosaly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaisselle Vega Rosaly reassigns Medicare benefits to Mente Activa (Ponce, PR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaisselle Vega Rosaly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jaisselle Vega Rosaly was last updated on July 25, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.