Active NPI
Nadya Noemi Rodriguez Rivera, MD
- General Practice Physician
- Ponce, PR
National Provider Identifier
1063015311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 22590
- Practice address
- 2225 Ponce by Pass
Parra Medical Plaza 905
Ponce, PR 00717 - Phone
- (787) 844-2710
- NPI assigned
- Nov 19, 2020
- Last updated
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 195-P.A. | PR | |
| General Practice Physician | 208D00000X | 22590 | PR | Primary |
Addresses
Primary practice location
2225 Ponce by Pass
Parra Medical Plaza 905
Ponce, PR 00717
Mailing address
HC 2 Box 14533
Guayanilla, PR 00656-9827
Phone (787) 420-4281
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 195-P.A. | PR | MD | Medical Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1063015311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 2 BOX 14533",
"city": "GUAYANILLA",
"state": "PR",
"postal_code": "006569827",
"telephone_number": "787-420-4281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 PONCE BY PASS",
"address_2": "PARRA MEDICAL PLAZA 905",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-844-2710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ RIVERA",
"first_name": "NADYA",
"middle_name": "NOEMI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2023-01-18",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "195-P.A.",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "22590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
- Kevin Alexis Rodriguez Perez
- Derek Mizael Rodriguez Pinero
- Ulises Rodriguez Ramos
- Adriana Del Pilar Rodriguez Rivas
- Laura E Rodriguez Rivera, M.D.
- Nixzaliz Rodriguez Rivera, M. D.
- Yosira Marie Rodriguez Rivera, MD
- Aida Rodriguez Robles
- Alissa Marie Rodriguez Rodriguez
- Jesus W Rodriguez Rodriguez, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.