Individual provider Active NPI

Selena Marie Rodriguez Rivera

  • Internal Medicine Physician
  • Mayaguez, PR
National Provider Identifier
1447707740
Registry record updated Mar 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23148 Issued in PR
Practice address
410 Ave Hostos
Mayaguez, PR 00682-1560
Phone
(787) 652-9200
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23148 PR
Internal Medicine Physician 207R00000X 23148 PR Primary

Addresses

Primary practice location

410 Ave Hostos
Mayaguez, PR 00682-1560

Mailing address

PO Box 600
Mayaguez, PR 00681-0600
Phone (787) 652-9200

Other names 1

  • Selena Marie Rodriguez 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
I20230913004395 PR Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0648525279 Practice locations: Mayaguez, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayaguez Medical Center Dr Ramon Emeterio Betances 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1447707740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810600",
            "telephone_number": "787-652-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 AVE HOSTOS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006821560",
            "telephone_number": "787-652-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ RIVERA",
        "first_name": "SELENA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "23148",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "23148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELENA",
            "last_name": "RODRIGUEZ",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.