Individual provider Active NPI

Clara L Rivera, MD

  • General Practice Physician
  • Naranjito, PR
National Provider Identifier
1164468922
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8290 Issued in PR
Practice address
Carr 164 KM 5 El Desvio Bo Achiote
Naranjito, PR 00719
Phone
(787) 869-4211
Fax
(787) 869-4211
NPI assigned
Jun 21, 2006
Last updated
Dec 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 8290 PR Primary

Addresses

Primary practice location

Carr 164 KM 5 El Desvio Bo Achiote
Naranjito, PR 00719

Mailing address

Box 872
Naranjito, PR 00719
Phone (787) 869-8392

Other identifiers 1

IdentifierTypeStateIssuer
83331OtherSSS

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
I20100616000890 PR Practitioner - General Practice 4082744180 Practice locations: Naranjito, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8290PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1164468922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 872",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "00719",
            "telephone_number": "787-869-8392",
            "fax_number": "787-869-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 164 KM 5 EL DESVIO BO ACHIOTE",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "00719",
            "telephone_number": "787-869-4211",
            "fax_number": "787-869-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "CLARA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "8290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "83331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naranjito, PR

Sources for this page

Verify at the official NPI Registry.