Individual provider Active NPI

Robert Rivera

  • Diagnostic Radiology Physician
  • Bayamon, PR
National Provider Identifier
1063406536
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13098 Issued in PR
Practice address
1815 Road # 2 KM 11.7
CT Radiology Complex BLDG
Bayamon, PR 00959-7279
Phone
(787) 780-9069
Fax
(787) 780-2121
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13098 PR Primary

Addresses

Primary practice location

1815 Road # 2 KM 11.7
CT Radiology Complex BLDG
Bayamon, PR 00959-7279

Mailing address

PO Box 602727
Bayamon, PR 00960-6037
Phone (787) 780-9069

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040807000153 PR Practitioner - Diagnostic Radiology 4284606559 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Puerto Rico School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Coto Laurel, PR 00780

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13098PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc. CurrentSince Nov 22, 2024 Accepting new patients
San Pablo Developers, Inc Diagnostic Radiology CurrentSince Jan 3, 2017 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Nov 22, 2024 Accepting new patients
Mennonite General Hospital Inc Current Accepting new patients
CT Radiology Complex, LLC Diagnostic Radiology CurrentSince Apr 14, 2004 Accepting new patients
Hospital Menonita Ponce Inc Diagnostic Radiology CurrentSince May 1, 2024 Accepting new patients
GRP Med CT Radiology Complex CurrentSince Apr 14, 2004 Accepting new patients
San Pablo Developers Inc CurrentSince Jan 3, 2017 Accepting new patients
M & P Radiologos, LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1063406536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602727",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009606037",
            "telephone_number": "787-780-9069",
            "fax_number": "787-780-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 ROAD # 2 KM 11.7",
            "address_2": "CT RADIOLOGY COMPLEX BLDG",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009597279",
            "telephone_number": "787-780-9069",
            "fax_number": "787-780-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "13098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.