Individual provider Active NPI

Jorge D Rivera Vargas, M.D.

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1457449902
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
008084 Issued in PR
Practice address
Carr 21 # 3T 4B
Urb Las Lomas
San Juan, PR 00921
Phone
(787) 781-1636
Fax
(787) 781-1636
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 008084 PR Primary

Addresses

Primary practice location

Carr 21 # 3T 4B
Urb Las Lomas
San Juan, PR 00921

Mailing address

PO Box 2077
Guaynabo, PR 00970-2077
Phone (787) 781-1636

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
I20110301000893 PR Practitioner - Internal Medicine 8820279425 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008084PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1457449902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009702077",
            "telephone_number": "787-781-1636",
            "fax_number": "787-781-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 21 # 3T 4B",
            "address_2": "URB LAS LOMAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-781-1636",
            "fax_number": "787-781-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA VARGAS",
        "first_name": "JORGE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "008084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.