Mayra Rivera Santiago, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME79661 Issued in FL

Practice address

17417 Bridgehill CT,
Tampa, FL 33647-2308

Phone

(813) 972-7900

Fax

(813) 355-5035

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Internal Medicine

Education

Michigan College of Medicine and Surgery, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
• H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: imt@flmed.directbygreenway.com

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.

• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Florida Medical Clinic, LLC

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Ohi West Medical Group II LLC

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Ohi West Medical Group II LLC

  • Physiological Laboratory
  • Zephyrhills, FL
  • NPI 1679344394
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

  • Special Hospital
  • Tampa, FL
  • NPI 1780653618
  Care Compare affiliation
• University Community Hospital, Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919
  Care Compare affiliation
• University Community Hospital, Inc

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1134766694

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1083646913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17417 BRIDGEHILL CT,",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472308",
            "telephone_number": "813-972-7900",
            "fax_number": "813-355-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA SANTIAGO",
        "first_name": "MAYRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260874000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00133424",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imt@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "17417 Bridgehill Ct,",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336472308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica Rivera Iraheta
• Elvin Rivera Marcano
• Heine Rivera Rodriguez Jr., MD
• Marielli Rivera Rodriguez
• Melissa Rivera Ruiz
• Rafael Angel Rivera Sepulveda
• Sailyn Rivera Valle
• Angelica Rivera-Cruz, M.D
• Lismarie Rivera-Fonseca
• Gabrielle Anne Rivera-Maldonado, MD

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.