Individual provider Active NPI

Paola Enid Rivera

  • Optometrist
  • Mayaguez, PR
National Provider Identifier
1043914500
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
766 Issued in PR
Practice address
Calle Zafiro 4 Urb. Vista Verde
Mayaguez, PR 00682
Phone
(787) 827-8101
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 766 PR Primary

Addresses

Primary practice location

Calle Zafiro 4 Urb. Vista Verde
Mayaguez, PR 00682

Mailing address

HC 3 Box 31301
Aguada, PR 00602-9754
Phone (862) 210-4246

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613003778 PR Practitioner - Optometry 4183082787 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
766PRMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vision One Corporation Optometrist CurrentSince May 1, 2023 Accepting new patients
Optical Supercenter Arecibo Corp Optometrist CurrentSince Sep 4, 2023 Accepting new patients

Locations

88 Calle Cordoba
Aguadilla, PR 00603
Phone (787) 830-9000

3241 Ave Militar
Isabela, PR 00662
Phone (787) 827-8101

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1043914500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 31301",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006029754",
            "telephone_number": "862-210-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ZAFIRO 4 URB. VISTA VERDE",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-827-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "PAOLA",
        "middle_name": "ENID",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.