Individual provider Active NPI

Jeovhanni Nieves

  • Family Medicine Physician
  • Cidra, PR
National Provider Identifier
1093765042
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15887 Issued in PR
Practice address
9 Carr 173
Oficina Medica Salida Aguas Buenas
Cidra, PR 00739-3512
Phone
(787) 273-1227
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15887 PR Primary

Addresses

Primary practice location

9 Carr 173
Oficina Medica Salida Aguas Buenas
Cidra, PR 00739-3512

Mailing address

PO Box 1512
Cidra, PR 00739-1512

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
I20050518000394 PR Practitioner - General Practice 1456392638 Practice locations: Cidra, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud Integral Caguas Past Accepting new patients
Municipio de Juncos Past Accepting new patients
Nieves Primary Care Center Past Accepting new patients
Municipio de Juncos Past Accepting new patients

Organizations & group practices 4

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1093765042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1512",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CARR 173",
            "address_2": "OFICINA MEDICA SALIDA AGUAS BUENAS",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007393512",
            "telephone_number": "787-273-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "JEOVHANNI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.