Individual provider Active NPI

Keren Rivera Gonzalez, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1063713345
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18086 Issued in PR
Practice address
5J22 Calle Parque Borinquen
Carolina, PR 00983-3718
Phone
(787) 513-3791
NPI assigned
Nov 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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 18086 PR Primary

Addresses

Primary practice location

5J22 Calle Parque Borinquen
Carolina, PR 00983-3718

Mailing address

PO Box 3195
Carolina, PR 00984-3195
Phone (787) 513-3791

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
I20130326000231 PR Practitioner - General Practice 8224273156 Reassigns benefits to 1 organization
Practice locations: Juncos, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cossma, Inc. CurrentSince Jan 30, 2022 Accepting new patients
Cossma Inc CurrentSince Jan 30, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1063713345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3195",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009843195",
            "telephone_number": "787-513-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5J22 CALLE PARQUE BORINQUEN",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009833718",
            "telephone_number": "787-513-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA GONZALEZ",
        "first_name": "KEREN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.