Organization Active NPI

Luis Adrian Rivera Pomales, MD, Mba, MPH, CCD, Dabbm, CSP

  • Internal Medicine Physician
  • Guayama, PR
National Provider Identifier
1033530829
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8309 Issued in PR
Legal business name
LUIS ADRIAN RIVERA POMALES, MD, MBA, MPH, CCD, DABBM, CSP
Practice address
Calle Ashford #62 Norte
Guayama, PR 00784
Phone
(787) 864-6570
Fax
(787) 866-8298
NPI assigned
Dec 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Luis Adrian Rivera-Pomales, M.D, M.B.A., M.P.H.,NPI 1649207028
Title
President/Owner
Phone
(707) 312-8054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 8309 PR Primary

Addresses

Primary practice location

Calle Ashford #62 Norte
Guayama, PR 00784

Mailing address

P.O. Box 1059
Arroyo, PR 00714
Phone (787) 864-6570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190425002198 PR Part B Supplier - Clinic/Group Practice 0143562009 Receives reassigned benefits from 1 practitioner
Practice locations: Guayama, PR; Patillas, PR

National Provider Directory

National Provider Directory

Locations

62 Calle Ashford N
Guayama, PR 00784
Phone (787) 864-6570

42 Calle Santiago Iglesias
Patillas, PR 00723
Phone (787) 510-2211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1033530829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1059",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "00714",
            "telephone_number": "787-864-6570",
            "fax_number": "787-866-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ASHFORD #62 NORTE",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-864-6570",
            "fax_number": "787-866-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS ADRIAN RIVERA POMALES, MD, MBA, MPH, CCD, DABBM, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "RIVERA-POMALES",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "707-312-8054",
        "authorized_official_credential": "M.D, M.B.A., M.P.H.,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.