Individual provider Active NPI

Carmen Marizor Nieves, M.D.

  • Family Medicine Physician
  • Rio Piedras, PR
National Provider Identifier
1255352746
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11981 Issued in PR
Practice address
10 Calle Casia
San Juan Vamc
Rio Piedras, PR 00921-3200
Phone
(787) 641-7582
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11981 PR Primary

Addresses

Primary practice location

10 Calle Casia
San Juan Vamc
Rio Piedras, PR 00921-3200

Mailing address

1307 Calle Mallorca
Mansiones Vistamar Marina
Carolina, PR 00983-1585
Phone (787) 257-7821

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11981PRMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255352746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 CALLE MALLORCA",
            "address_2": "MANSIONES VISTAMAR MARINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009831585",
            "telephone_number": "787-257-7821",
            "fax_number": "787-257-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALLE CASIA",
            "address_2": "SAN JUAN VAMC",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "CARMEN",
        "middle_name": "MARIZOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "11981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.