Miguel A Matta Rivera, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22294 Issued in PR

Practice address

Urb Miradero Camino del Monte 168
Humacao, PR 00791

Phone

(787) 414-4434

NPI assigned

May 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1295301505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB MIRADERO CAMINO DEL MONTE 168",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-414-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB MIRADERO CAMINO DEL MONTE 168",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-414-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA RIVERA",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-28",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariely Martinez Martinez Sr.
• Pedro Concepcion Martinez
• Rut Noemi Martinez, PHARMACY TECHNICIAN
• Sandra Martinez, RPHA
• Mas Salud IV LLC
• Indira E Matute Mendoza, 17,668-I
• Hector Rafael Maymi, M.D.
• MB Clinical Laboratories Corp.
• MB Clinical Laboratories Corp. (Laboratorio Clinico Villa Ana Humacao)
• Mci Land Corporation (Laboratorio Clinico Pitahaya)

• General Practice Physician in Humacao, PR
• Providers in Humacao, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.