Individual provider Active NPI

Fernando Eugenio Roura Rizzo, MD

  • General Practice Physician
  • Guaynabo, PR
National Provider Identifier
1063481810
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14929 Issued in PR
Practice address
405 Esmeralda Ave.
Suite 102 PMB 365
Guaynabo, PR 00969-4466
Phone
(787) 596-1110
NPI assigned
Mar 15, 2006
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14929 PR Primary

Addresses

Primary practice location

405 Esmeralda Ave.
Suite 102 PMB 365
Guaynabo, PR 00969-4466

Mailing address

405 Esmeralda Ave.
Suite 102 PMB 365
Guaynabo, PR 00969-4466
Phone (787) 596-1110

Other names 1

  • Dr. Fernando Roura Rizzo Professional name

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
I20050126000577 PR Practitioner - General Practice 0547210601 Reassigns benefits to 2 organizations
Practice locations: Guaynabo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Providers LLCGroup PAC ID 9436436706, 18 clinicians

Practice addresses (Care Compare)

435 Ave Constitucion
Villas de Parkville 2
San Juan, PR 00901-2212
Phone (787) 436-0727

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Administracion de Servicios Medicos de Puerto Rico CurrentSince Nov 23, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1063481810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ESMERALDA AVE.",
            "address_2": "SUITE 102 PMB 365",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694466",
            "telephone_number": "787-596-1110",
            "fax_number": "787-790-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ESMERALDA AVE.",
            "address_2": "SUITE 102 PMB 365",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694466",
            "telephone_number": "787-596-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROURA RIZZO",
        "first_name": "FERNANDO",
        "middle_name": "EUGENIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNANDO",
            "last_name": "ROURA RIZZO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.