Hector J Rivera Jacquez, MD PHD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

112769 Issued in GA

Practice address

1601 Watson Blvd
Warner Robins, GA 31093-3431

Phone

(478) 922-4281

NPI assigned

May 15, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1134910482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "478-922-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "478-922-4281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Ave Ponce De Leon",
            "address_purpose": "LOCATION",
            "city": "Hato Rey",
            "state": "PR",
            "postal_code": "009175032",
            "country_code": "US",
            "telephone_number": "787-758-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA JACQUEZ",
        "first_name": "HECTOR",
        "middle_name": "J",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "112769",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "17389-I",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Taylor Rinehart
• Kelley Michelle Ringley, PHARMD
• Stephanie Rivas
• River Edge Behavioral Health Center
• Ana Marie Rivera Betancourt, MD
• Mariel Rivera Olivera
• Rivera Pena and Associates Corp
• James Earl Roach
• April Roberson, LPN
• Robert H. Connell, PH.D.

• Student in an Organized Health Care Education/Training Program in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.