Individual provider Active NPI

Ileana Ivette Rivera-Burgos, MD

  • Rheumatology Physician
  • Ponce, PR
National Provider Identifier
1003131996
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
21954 Issued in PR
Practice address
1010 Paseo del Veterano
Ponce, PR 00716-2001
Phone
(787) 492-0112
NPI assigned
Apr 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1565 PR
Internal Medicine Physician 207R00000X 21954 PR
Rheumatology Physician 207RR0500X 21954 PR Primary

Addresses

Primary practice location

1010 Paseo del Veterano
Ponce, PR 00716-2001

Mailing address

1010 Paseo del Veterano
Ponce, PR 00716-2001
Phone (787) 492-0112

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812000658 PR Practitioner - Rheumatology 3072051952 Reassigns benefits to 1 organization
Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1565PRMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Anesthesia Associates LLC Current Accepting new patients
Hospital Damas Inc Rheumatology CurrentSince Sep 1, 2024 Accepting new patients
Liga Puertorriquena Contra El Cancer PastSince Aug 25, 2019 Accepting new patients

Locations

2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802

1010 Paseo del Veterano
Ponce, PR 00716
Phone (787) 492-0111

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Damas Inc 9 clinicians

Practice addresses (Care Compare)

1010 Paseo del Veterano
Ponce, PR 00716-2001
Phone 78749201112191

NPI Registry JSON

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1003131996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PASEO DEL VETERANO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162001",
            "telephone_number": "787-492-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PASEO DEL VETERANO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162001",
            "telephone_number": "787-492-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-BURGOS",
        "first_name": "ILEANA",
        "middle_name": "IVETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-02",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1565",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "21954",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PR",
            "license": "21954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.