Rene Rivera Collazo Sr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4584 Issued in PR

Practice address

Santa Rosa Mall
Suite 218
Bayamon, PR 00961

Phone

(787) 798-3967

Fax

(787) 269-5686

NPI assigned

Nov 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrative PM & R

  • Physical Medicine & Rehabilitation Physician
  • Bayamon, PR
  • NPI 1366314874

  Single Specialty

  NPD

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1437814167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CALLE HECTOR PANTOJAS",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006934031",
            "telephone_number": "787-515-0038",
            "fax_number": "787-269-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTA ROSA MALL",
            "address_2": "SUITE 218",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-798-3967",
            "fax_number": "787-269-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA COLLAZO",
        "first_name": "RENE",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "4584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA",
            "identifier": "4584",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "medicinadeportivajamy2019@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "SANTA ROSA MALL",
            "address_2": "SUITE 218",
            "city": "BAYAMON",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lino Daniel Rivera Arbelo, MD
• Marangely Rivera Ayala
• Cesar Yullian Rivera Barreto, MD
• Iris F Rivera Bermudez, PSYCHOLOGIST
• Ileana Rivera Bonilla, MD
• Dalinette Rivera Colon, RPT
• Angel Raul Rivera Cotto Sr., MD
• Ellen Christina Rivera Cruz, M.D.
• Jeannete Rivera Cruz, LIC.
• Tatiana Rivera Cruz, LCSW

• Physical Therapist in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Physical Therapist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.