Jaclismar Berrios-Rivera
Individual provider Active NPI Family Medicine Physician · Carolina, PR
NPI 1144637992 · NPPES record last updated Jun 12, 2019
Key facts
- NPI
- 1144637992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 19603 (PR)
- Practice address
- HC 3 Box 12052
Carolina, PR 00987-9617 - Phone
- (939) 639-4876
- NPI assigned
- Jul 14, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190816000121 | PR | Practitioner - Family Practice | 8820325665 | Practice locations: Carolina, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19603 | PR | MD | Family Medicine Physician |
Interoperability endpoints
- sjcjberrio@yourcarecommunity.org
- jaclismar.berriosrivera.p1@direct.vitacare.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19603 | PR | Yes |
Addresses
Primary practice location
HC 3 Box 12052
Carolina, PR 00987-9617
Mailing address
HC 3 Box 12052
Carolina, PR 00987-9617
Phone (939) 639-4876
Other providers in Carolina, PR
- Francisco L. Bermudez Segarra
- Maria M Bermudez
- Domingo Alberto Bernier Leon
- Yomayra Berrios Lopez
- Berrios Medicina de Familia
- Angel Berrios
- Heidi Rosa Berrios
- Idenisse M Berrios
- Dania Berroa
- Jossepp Berry-Polanco
All providers in Carolina, PR · Family Medicine Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.