Individual provider Active NPI

Iksen Rivera-Morales, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1073733127
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11264 Issued in PR
Practice address
1441 Ave FD Roosevelt
Division de Recursos Humanos, Triple-S Management Corp
San Juan, PR 00920-2717
Phone
(787) 380-4111
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2589 PR
General Practice Physician 208D00000X 11264 PR Primary

Addresses

Primary practice location

1441 Ave FD Roosevelt
Division de Recursos Humanos, Triple-S Management Corp
San Juan, PR 00920-2717

Mailing address

PO Box 4291
Bay GDNS Station
Bayamon, PR 00958-1291

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2589PRMDCounseling Psychologist
11264PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1073733127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4291",
            "address_2": "BAY GDNS STATION",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009581291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVE FD ROOSEVELT",
            "address_2": "DIVISION DE RECURSOS HUMANOS, TRIPLE-S MANAGEMENT CORP",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009202717",
            "telephone_number": "787-380-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-MORALES",
        "first_name": "IKSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "2589",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.