Individual provider Active NPI

Yadira Vazquez Rivera, M.D.

  • General Practice Physician
  • Cabo Rojo, PR
National Provider Identifier
1447446067
Registry record updated Sep 23, 2019
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
12411 Issued in PR
Practice address
Carr 100 KM 6.6
Bo. Miradero
Cabo Rojo, PR 00623
Phone
(939) 299-8168
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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 12411 PR Primary

Addresses

Primary practice location

Carr 100 KM 6.6
Bo. Miradero
Cabo Rojo, PR 00623

Mailing address

PO Box 1372
Hormigueros, PR 00660-5372
Phone (939) 299-8168

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
I20040701000181 PR Practitioner - General Practice 5991782609 Practice locations: Mayaguez, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12411PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1447446067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1372",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006605372",
            "telephone_number": "939-299-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 100 KM 6.6",
            "address_2": "BO. MIRADERO",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "939-299-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ RIVERA",
        "first_name": "YADIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabo Rojo, PR

Sources for this page

Verify at the official NPI Registry.