Active NPI
Jean Paul Inesta Rivera, MD
- General Practice Physician
- Brandon, FL
National Provider Identifier
1356904072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 22585
- Practice address
- 119 Oakfield Dr
Brandon, FL 33511-5779 - Phone
- (813) 681-5551
- Fax
- (813) 916-2944
- NPI assigned
- Apr 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 22585 | PR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | FL | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | 5039722 | PR |
Addresses
Primary practice location
119 Oakfield Dr
Brandon, FL 33511-5779
Mailing address
Suite 261
PO Box 19400
San Juan, PR 00919-4000
Phone (787) 406-3197
Other practice location 1
Dr Jose Celso Barbosa Drive
University of Puerto Rico, Medical Sciences Campus
San Juan, PR 00921
Phone (787) 758-2525
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22585 | Other | PR | MEDICAL LICENSE |
| 5039722 | Other | PR | DRIVER LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22585 | PR | MD | General Practice Physician |
| 5039722 | PR | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1356904072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SUITE 261",
"address_2": "PO BOX 19400",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009194000",
"telephone_number": "787-406-3197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 OAKFIELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115779",
"telephone_number": "813-681-5551",
"fax_number": "813-916-2944"
}
],
"practiceLocations": [
{
"address_1": "Dr Jose Celso Barbosa Drive",
"address_2": "University of Puerto Rico, Medical Sciences Campus",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "00921",
"country_code": "US",
"telephone_number": "787-758-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INESTA RIVERA",
"first_name": "JEAN PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-18",
"last_updated": "2021-12-20",
"certification_date": "2021-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "22585",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "5039722",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "22585",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "5039722",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.