Active NPI
Roberto Rivera Dominguez
- Hospitalist Physician
- San Juan, PR
National Provider Identifier
1154718294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 21774
- Practice address
- VA Caribbean Healthcare System 10 Calle Casia
San Juan, PR 00921 - Phone
- (787) 641-7582
- NPI assigned
- Apr 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21774 | PR | |
| Hospitalist Physician | 208M00000X | 21774 | PR | Primary |
Addresses
Primary practice location
VA Caribbean Healthcare System 10 Calle Casia
San Juan, PR 00921
Mailing address
PO Box 9429
Bayamon, PR 00960-9429
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21774 | PR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1154718294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9429",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009609429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA CARIBBEAN HEALTHCARE SYSTEM 10 CALLE CASIA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00921",
"telephone_number": "787-641-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA DOMINGUEZ",
"first_name": "ROBERTO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-15",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PR",
"license": "21774",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "PR",
"license": "21774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
- Jonathan Eduardo Rivera Declet
- Nashalie Enid Rivera Delfi
- Nycolle Rivera Diaz
- Victoria Samantha Rivera Diaz
- Paola Rivera Dilan
- Asdrubal Enrique Rivera Dones
- Maria del Mar Rivera Echeandia, M.S., CCC-SLP
- Francisco Gabriel Rivera Emanuelli
- Rivera Emotional Health Center, LLC
- Edgardo J Rivera Escobar, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.