Gastrointestinal Diagnostic Clinic of PR, LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

18138 Issued in PR

Legal business name

GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC

Practice address

Calle Sgto. Hernandez Carrion
MMC Professional Plaza, Suite 307
Manati, PR 00674

Phone

(787) 884-0310

Fax

(787) 854-3270

NPI assigned

Jun 3, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Rivera de Jesus, M.D.

Title

Owner

Phone

(787) 646-9724

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Rivera, M.D.

  • Internal Medicine Physician
  • Hatillo, PR
  • NPI 1235334400
  Medicare reassignment

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1316384100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 AVE LUIS VIGOREAUX",
            "address_2": "PMB 389",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662715",
            "telephone_number": "787-884-0310",
            "fax_number": "787-854-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SGTO. HERNANDEZ CARRION",
            "address_2": "MMC PROFESSIONAL PLAZA, SUITE 307",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-884-0310",
            "fax_number": "787-854-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "RIVERA DE JESUS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-646-9724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "PR",
            "license": "18138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose G Garcia, M.D.
• Liz Garcia
• Marielina Garcia, MD
• Nestor E. Garcia, PSY D.
• Gastro Atenas LLC
• Angel Luis Gelpi Guzman, MD
• Gemi, PSC
• Gemigm LLC
• Gemipsc
• Geo Drug Store Pharmacy, Inc.

• Endoscopy Clinic/Center in Manati, PR
• Providers in Manati, PR by specialty
• Endoscopy Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.