Individual provider Active NPI

Ricardo Andres Rivera-Cruz, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1346995958
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23412 Issued in PR
Practice address
986-990 CLL 42 SE, San Juan, 00921, Puerto Rico
San Juan, PR 00921
Phone
(787) 201-8937
NPI assigned
Feb 14, 2022
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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 23412 PR Primary

Addresses

Primary practice location

986-990 CLL 42 SE, San Juan, 00921, Puerto Rico
San Juan, PR 00921

Mailing address

PO Box 880
Camuy, PR 00627-0880
Phone (787) 201-8937

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
I20241010004053 PR Practitioner - General Practice 3971035262 Practice locations: Humacao, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23412PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1346995958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006270880",
            "telephone_number": "787-201-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986-990 CLL 42 SE, SAN JUAN, 00921, PUERTO RICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-201-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-CRUZ",
        "first_name": "RICARDO",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.