Individual provider Active NPI

Lisandra Rivera Aviles, OT

  • Occupational Therapist
  • Vega Alta, PR
National Provider Identifier
1114210796
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
966 Issued in PR
Practice address
Carretera 693 Bo. Brenas
Edif. Anchor Heart Suite 6
Vega Alta, PR 00692
Phone
(787) 270-2686
Fax
(787) 270-5292
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 966 PR Primary

Addresses

Primary practice location

Carretera 693 Bo. Brenas
Edif. Anchor Heart Suite 6
Vega Alta, PR 00692

Mailing address

PO Box 468
Vega Baja, PR 00694-0468
Phone (787) 596-3497

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

State licenses

LicenseStateTypeSpecialty
966PRMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida de la Salud Corp Past Accepting new patients
Nueva Vida de la Salud II Past Accepting new patients

Organizations & group practices 2

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1114210796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006940468",
            "telephone_number": "787-596-3497",
            "fax_number": "787-270-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 693 BO. BRENAS",
            "address_2": "EDIF. ANCHOR HEART SUITE 6",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-270-2686",
            "fax_number": "787-270-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA AVILES",
        "first_name": "LISANDRA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PR",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.