Individual provider Active NPI

Cosmarie M Cortes Rivera

  • General Practice Physician
  • Anasco, PR
National Provider Identifier
1295971646
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17451 Issued in PR
Practice address
Carr 404 KM 1.1. Apt 2a Bo Daguey
Anasco, PR 00610
Phone
(787) 475-6054
NPI assigned
Jan 6, 2009
Last updated
Jan 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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 17451 PR Primary

Addresses

Primary practice location

Carr 404 KM 1.1. Apt 2a Bo Daguey
Anasco, PR 00610

Mailing address

PO Box 619
Anasco, PR 00610-0619
Phone (787) 475-6054

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
I20090518000409 PR Practitioner - General Practice 7214086487 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17451PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champi Medical and Wellness Group General Practice CurrentSince Jan 1, 2014 Accepting new patients
Champi Medical and Wellness Group Corp Past Accepting new patients

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": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1295971646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 619",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006100619",
            "telephone_number": "787-475-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 404 KM 1.1. APT 2A BO DAGUEY",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "00610",
            "telephone_number": "787-475-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTES RIVERA",
        "first_name": "COSMARIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anasco, PR

Sources for this page

Verify at the official NPI Registry.