Individual provider Active NPI

Jose Luis Riestra, MD

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1184698797
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5936 Issued in PR
Practice address
68 Calle Santa Cruz
Torre San Pablo, Suite 904
Bayamon, PR 00961-7031
Phone
(787) 780-5369
Fax
(787) 780-5527
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5936 PR Primary

Addresses

Primary practice location

68 Calle Santa Cruz
Torre San Pablo, Suite 904
Bayamon, PR 00961-7031

Mailing address

Y2 Calle Hastings
Garden Hills
Guaynabo, PR 00966-2832
Phone (787) 781-6889

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
I20120424000493 PR Practitioner - EndocrinologyPractitioner - Internal Medicine 4082876826 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5936PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184698797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "Y2 CALLE HASTINGS",
            "address_2": "GARDEN HILLS",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662832",
            "telephone_number": "787-781-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CALLE SANTA CRUZ",
            "address_2": "TORRE SAN PABLO, SUITE 904",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617031",
            "telephone_number": "787-780-5369",
            "fax_number": "787-780-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESTRA",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "5936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.