Individual provider Active NPI

Yamilette Rivera Rivera, MD

  • Emergency Medicine Physician
  • San Juan, PR
National Provider Identifier
1205328341
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21347 Issued in PR
Practice address
Centro Medico Barrio Monacillos
San Juan, PR 00936
Phone
(787) 480-2805
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31024 MS
Emergency Medicine Physician 207P00000X 21347 PR Primary

Addresses

Primary practice location

Centro Medico Barrio Monacillos
San Juan, PR 00936

Mailing address

47 Calle Rocio
Urb Paseo de Las Brumas
Cayey, PR 00736
Phone (787) 605-3146

Other practice location 1

150 Reynoir St
Biloxi, MS 39530-4130
Phone (228) 432-1571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20230301002134 MS Practitioner - Emergency Medicine 7810360401 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31024MSMDEmergency Medicine Physician
21347PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison Emergency Group LLC Emergency Medicine CurrentSince Jan 16, 2023 Accepting new patients
Mississippi Emergency Department Services PC Emergency Medicine CurrentSince Jan 10, 2025 Accepting new patients

Locations

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1205328341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CALLE ROCIO",
            "address_2": "URB PASEO DE LAS BRUMAS",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-605-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO MEDICO BARRIO MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-480-2805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Reynoir St",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395304130",
            "country_code": "US",
            "telephone_number": "228-432-1571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA RIVERA",
        "first_name": "YAMILETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "31024",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "21347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.