Individual provider Active NPI

Lourdes M. Fuentes Rivera, PT.

  • Physical Therapist
  • Bayamon, PR
National Provider Identifier
1003198755
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
000724 Issued in PR
Practice address
Urb. Jardines de Caparra
Calle 13 F18
Bayamon, PR 00959-0000
Phone
(787) 397-6253
Fax
(787) 785-5041
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 000724 PR Primary

Addresses

Primary practice location

Urb. Jardines de Caparra
Calle 13 F18
Bayamon, PR 00959-0000

Mailing address

Urb. Jardines de Caparra
Calle 13 F18
Bayamon, PR 00959-0000
Phone (787) 397-6253

Other names 1

  • Lourdes M. Fuentes Rivera Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230000137 PR Practitioner - Physical Therapist in Private Practice 5799198297 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
724PRMDChiropractor
000724PRMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics & Sports Medicine P.S.C. CurrentSince Nov 12, 2020 Accepting new patients
Athletic Training and Rehab Center LLC CurrentSince Nov 12, 2020 Accepting new patients

Locations

BH9 Calle Quintana
Bayamon, PR 00956
Phone (939) 264-1889

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1003198755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. JARDINES DE CAPARRA",
            "address_2": "CALLE 13 F18",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009590000",
            "telephone_number": "787-397-6253",
            "fax_number": "787-785-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. JARDINES DE CAPARRA",
            "address_2": "CALLE 13 F18",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009590000",
            "telephone_number": "787-397-6253",
            "fax_number": "787-785-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES RIVERA",
        "first_name": "LOURDES",
        "middle_name": "M.",
        "credential": "PT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "000724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOURDES",
            "last_name": "FUENTES RIVERA",
            "middle_name": "M.",
            "credential": "PT.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.