Active NPI
Mireya Baez-Rivera
- Registered Dietitian
- Arecibo, PR
National Provider Identifier
1073972956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1297
- Practice address
- Carr 129 KM 0.1 Ave San Luis
Dr. Susoni Health Community Service, Corp.
Arecibo, PR 00612 - Phone
- (787) 650-7272
- Fax
- (787) 650-7248
- NPI assigned
- Feb 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1297 | PR | Primary |
Addresses
Primary practice location
Carr 129 KM 0.1 Ave San Luis
Dr. Susoni Health Community Service, Corp.
Arecibo, PR 00612
Mailing address
Carr 129 KM 0.1 Ave San Luis
Dr. Susoni Health Community Service, Corp.
Arecibo, PR 00612
Phone (787) 650-7272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1297 | Other | PR | PROFESSIONAL LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1297 | PR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1073972956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CARR 129 KM 0.1 AVE SAN LUIS",
"address_2": "DR. SUSONI HEALTH COMMUNITY SERVICE, CORP.",
"city": "ARECIBO",
"state": "PR",
"postal_code": "00612",
"telephone_number": "787-650-7272",
"fax_number": "787-650-7248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 129 KM 0.1 AVE SAN LUIS",
"address_2": "DR. SUSONI HEALTH COMMUNITY SERVICE, CORP.",
"city": "ARECIBO",
"state": "PR",
"postal_code": "00612",
"telephone_number": "787-650-7272",
"fax_number": "787-650-7248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEZ-RIVERA",
"first_name": "MIREYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-19",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1297",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "1297",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arecibo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.