Individual provider Active NPI

Miriam Rivera Serrano, MD

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1255362885
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9679 Issued in PR
Practice address
Carr #2 KM 65.6
Bo Factor 1
Arecibo, PR 00612
Phone
(787) 881-2953
Fax
(787) 881-4807
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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 9679 PR Primary

Addresses

Primary practice location

Carr #2 KM 65.6
Bo Factor 1
Arecibo, PR 00612

Mailing address

PO Box 970
Arecibo, PR 00613-0970
Phone (787) 881-2953

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
I20071022000495 PR Practitioner - General Practice 0749376770 Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Carretera 2 KM
6 Barrio Factor
Arecibo, PR 00613
Phone (787) 815-6536

PO Box
Arecibo, PR 00613

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9679PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1255362885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006130970",
            "telephone_number": "787-881-2953",
            "fax_number": "781-881-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #2 KM 65.6",
            "address_2": "BO FACTOR 1",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-881-2953",
            "fax_number": "787-881-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA SERRANO",
        "first_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.