Active NPI
Paola Sofia Rivera Bernaola, MD, MPH
- Family Medicine Physician
- Carolina, PR
National Provider Identifier
1073222154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17167
- Practice address
- KM 8.3 Calle 3
Av. 65 de Infanteria
Carolina, PR 00984 - Phone
- (787) 476-4135
- NPI assigned
- Nov 17, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 17167 | PR | Primary |
Addresses
Primary practice location
KM 8.3 Calle 3
Av. 65 de Infanteria
Carolina, PR 00984
Mailing address
PO Box 823
Fajardo, PR 00738-0823
Phone (787) 632-0210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17167 | PR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1073222154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 823",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007380823",
"telephone_number": "787-632-0210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "KM 8.3 CALLE 3",
"address_2": "AV. 65 DE INFANTERIA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00984",
"telephone_number": "787-476-4135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA BERNAOLA",
"first_name": "PAOLA",
"middle_name": "SOFIA",
"name_prefix": "Miss",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-17",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PR",
"license": "17167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.