Individual provider Active NPI

Ricardo E Rivera, M.D.

  • Diagnostic Radiology Physician
  • San Juan, PR
National Provider Identifier
1255301214
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15838 Issued in PR
Practice address
400 Ave Domenech
Suite 101
San Juan, PR 00918-3710
Phone
(787) 705-5677
NPI assigned
Jan 24, 2006
Last updated
May 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 15838 PR
Diagnostic Radiology Physician 2085R0202X 15838 PR Primary
Diagnostic Ultrasound Physician 2085U0001X 15838 PR

Addresses

Primary practice location

400 Ave Domenech
Suite 101
San Juan, PR 00918-3710

Mailing address

PO Box 190679
San Juan, PR 00919-0679
Phone (787) 705-5677

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
I20051220000023 PR Practitioner - Diagnostic Radiology 3971525932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University Central del Caribe Escuela de Medicina, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Domenech Ave
101 Las Americas Professional Center
San Juan, PR 00918
Phone (787) 705-5677

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15838PRMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro Skeletal Imaging PSC Diagnostic Radiology CurrentSince Jul 1, 2009 Accepting new patients
Arraiza Radiology PSC Diagnostic Radiology Past Accepting new patients

Locations

400 Ave Domenech
Ste 101
San Juan, PR 00918
Phone (787) 705-5677

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1255301214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190679",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009190679",
            "telephone_number": "787-705-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVE DOMENECH",
            "address_2": "SUITE 101",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183710",
            "telephone_number": "787-705-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RICARDO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PR",
            "license": "15838",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "15838",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "PR",
            "license": "15838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.