Individual provider Active NPI

Robert Rivera, M.D.

  • General Practice Physician
  • Cidra, PR
National Provider Identifier
1417038969
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9611 Issued in PR
Practice address
Ave. El Jibaro Hospital Menonita Cidra
Oficina 105
Cidra, PR 00739-0459
Phone
(787) 739-6688
Fax
(787) 739-6688
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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 9611 PR Primary

Addresses

Primary practice location

Ave. El Jibaro Hospital Menonita Cidra
Oficina 105
Cidra, PR 00739-0459

Mailing address

PO Box 459
Cidra, PUERTO RICO 00739 0459
UM
Phone (787) 739-6688

Other names 1

  • Robert Rivera Quiles Other name

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
I20131114001054 PR Practitioner - General Practice 1658507934 Practice locations: Cidra, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9611PRMDClinical Laboratory Director (Non-physician)

Practice roles

OrganizationSpecialtyStatusNew patients
RW Lab LLC CurrentSince Nov 15, 2022 Accepting new patients
Cidra & Montana, LLC PastSince May 24, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1417038969",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "PO BOX 459",
            "city": "CIDRA",
            "state": "PUERTO RICO",
            "postal_code": "00739 0459",
            "telephone_number": "787-739-6688",
            "fax_number": "787-739-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. EL JIBARO HOSPITAL MENONITA CIDRA",
            "address_2": "OFICINA 105",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007390459",
            "telephone_number": "787-739-6688",
            "fax_number": "787-739-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "RIVERA QUILES",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.