Antonio Rivera Santiago

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2138 Issued in PR

Practice address

300 Ave. Font Martelo
Oficinas Medicas Menonita
Humacao, PR 00791

Phone

(787) 852-0505

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1003969544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 TWILIGHT ST",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916305",
            "telephone_number": "787-640-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 AVE. FONT MARTELO",
            "address_2": "OFICINAS MEDICAS MENONITA",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-852-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Calle Nazario",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007252683",
            "country_code": "US",
            "telephone_number": "787-653-6775",
            "fax_number": "787-653-6779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA SANTIAGO",
        "first_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PR",
            "license": "2138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Jose Rivera Gomez, PSY-D
• Diomara Beatriz Rivera Laboy, SPEECH THERAPIST
• Gina Liz Rivera Lao
• Nilda Ebony Rivera Ortiz
• Delmara Rivera Rivera, PSY D
• Jose A Rivera Vega, RN
• Pedro Antonio Rivera Vega, RN
• Alma V. Rivera, M.D.
• Andrea Gabriella Rivera, MS
• Carmelo Rivera, LPN

• Clinical Neuropsychologist in Humacao, PR
• Providers in Humacao, PR by specialty
• Clinical Neuropsychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.