Otilio Jose Rivera, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

15901 Issued in PR

Practice address

Carretera 22
Barrio Monacillos, Rio Piedras
San Juan, PR 00919

Phone

(787) 777-3232

NPI assigned

Apr 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1336769884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2052",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006132052",
            "telephone_number": "787-397-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 22",
            "address_2": "BARRIO MONACILLOS, RIO PIEDRAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00919",
            "telephone_number": "787-777-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "OTILIO",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "15901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "otilio.rivera1@upr.edu",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Hospital Pediatrico Universitario",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Carretera 22",
            "address_2": "Barrio Monacillos, Rio Piedras",
            "city": "San Juan",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nereida Rivera, CRNA
• Neysha M Rivera, MRC
• Nicole Melissa Rivera, DMD
• Nilda E. Rivera
• Norma Iris Rivera, OTR/L
• Paola Nicole Rivera
• Patricia Rivera
• Pedro Rivera, RPH
• Pedro Ivan Rivera, M.D.
• Pedro J Rivera Sr., RN

• Pediatrics Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.