Individual provider Active NPI

David Rivera-Jimenez, M.D.

  • Family Medicine Physician
  • Arecibo, PR
National Provider Identifier
1255495909
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10193 Issued in PR
Practice address
CDT Villa Los Santos
Calle 16-V-1,Urb. Villa Los Santos
Arecibo, PR 00612
Phone
(787) 878-9844
Fax
(787) 880-1143
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2017

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 10193 PR Primary

Addresses

Primary practice location

CDT Villa Los Santos
Calle 16-V-1,Urb. Villa Los Santos
Arecibo, PR 00612

Mailing address

PO Box 9980
Cotto Station
Arecibo, PR 00613-9980
Phone (787) 817-3144

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
I20050503000015 PR Practitioner - Family Practice 5698714293 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10193PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratorio Clinico Villa Los Santos Current Accepting new patients
Servicios de Salud del Norte Family Medicine CurrentSince Jan 31, 2012 Accepting new patients
Centro de Salud de Lares, Inc. Past Accepting new patients

Locations

V1 Calle 16
Arecibo, PR 00612
Phone (787) 817-3144

Organizations & group practices 3

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1255495909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9980",
            "address_2": "COTTO STATION",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006139980",
            "telephone_number": "787-817-3144",
            "fax_number": "787-879-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CDT VILLA LOS SANTOS",
            "address_2": "CALLE 16-V-1,URB. VILLA LOS SANTOS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-878-9844",
            "fax_number": "787-880-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-JIMENEZ",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "10193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.