Individual provider Active NPI

Ivan Augusto Rivera Nazario, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • San Juan, PR
National Provider Identifier
1124554449
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
21051 Issued in PR
Practice address
Hospital Municipal de San Juan Barrio Monacillo
Centro Medico de Puerto Rico
San Juan, PR 00928
Phone
(787) 480-0000
NPI assigned
May 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 21051 PR Primary

Addresses

Primary practice location

Hospital Municipal de San Juan Barrio Monacillo
Centro Medico de Puerto Rico
San Juan, PR 00928

Mailing address

PO Box 191811
San Juan, PR 00919-1811
Phone (787) 763-4149

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
I20190513001964 PR Practitioner - Internal MedicinePractitioner - General Practice 2062755184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1507 Ave Juan Ponce de Leon
Suite 205
San Juan, PR 00909-2050
Phone (787) 579-3028

Hospital & facility affiliations

  • Doctors' Center Hospital San Juan Hospital, Santurce, PR, CCN 400006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21051PRMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RN Endocrinology LLC Endocrinology, Diabetes & Metabolism CurrentSince Sep 21, 2025 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Nov 9, 2018 Accepting new patients
Nieves Internal Medicine Health Internal Medicine CurrentSince Jan 3, 2024 Accepting new patients
Centro Medico del Turabo Inc General Practice CurrentSince Nov 9, 2018 Accepting new patients

Locations

70 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 620-1639

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1124554449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191811",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009191811",
            "telephone_number": "787-763-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL MUNICIPAL DE SAN JUAN BARRIO MONACILLO",
            "address_2": "CENTRO MEDICO DE PUERTO RICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00928",
            "telephone_number": "787-480-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA NAZARIO",
        "first_name": "IVAN",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2024-08-01",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PR",
            "license": "21051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.