Individual provider Active NPI

Ismael Rodriguez-Rivera, MD, BC

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1487620340
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11799 Issued in PR
Practice address
64 Calle Santa Cruz
Galeria Medica Suite 106
Bayamon, PR 00961-7003
Phone
(787) 785-8600
NPI assigned
Feb 28, 2006
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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 11799 PR Primary

Addresses

Primary practice location

64 Calle Santa Cruz
Galeria Medica Suite 106
Bayamon, PR 00961-7003

Mailing address

PO Box 2697
Bayamon, PR 00960-2697
Phone (787) 785-6506

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
I20110404000114 PR Practitioner - Internal Medicine 9032393889 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Puerto Rico School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 Calle Santa Cruz
Bayamon, PR 00961-7003
Phone (787) 785-8600

64 Santa Cruz Ave
Galeria Medica Suite 106
Bayamon, PR 00961-7003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11799PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1487620340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2697",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009602697",
            "telephone_number": "787-785-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CALLE SANTA CRUZ",
            "address_2": "GALERIA MEDICA SUITE 106",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617003",
            "telephone_number": "787-785-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-RIVERA",
        "first_name": "ISMAEL",
        "name_prefix": "Dr.",
        "credential": "MD, BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.