Individual provider Active NPI

Omayra Rivera Rivera, PH.D.

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1356378814
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2290 Issued in PR
Practice address
1666 Calle Parana
San Juan, PR 00926-3145
Phone
(787) 608-0433
NPI assigned
Jun 28, 2006
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2290 PR Primary

Addresses

Primary practice location

1666 Calle Parana
San Juan, PR 00926-3145

Mailing address

314 Sect Pitillo
Mayaguez, PR 00682-7303
Phone (787) 608-0433

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000552 PR Practitioner - Clinical Psychologist 4284605650 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1666 Calle Parana
San Juan, PR 00926-3145
Phone (787) 608-0433

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2290PRMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Support Services, Inc Past Accepting new patients

Organizations & group practices 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1356378814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 SECT PITILLO",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006827303",
            "telephone_number": "787-608-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 CALLE PARANA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263145",
            "telephone_number": "787-608-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA RIVERA",
        "first_name": "OMAYRA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.