Individual provider Active NPI

Roberto J. Ayala Rios, M.D.

  • General Practice Physician
  • Anasco, PR
National Provider Identifier
1518197136
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17640 Issued in PR
Practice address
65 De Infanteria 67
Suite 104-109
Anasco, PR 00610
Phone
(787) 826-2145
Fax
(787) 826-7411
NPI assigned
Jul 16, 2009
Last updated
Aug 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 17640 PR Primary

Addresses

Primary practice location

65 De Infanteria 67
Suite 104-109
Anasco, PR 00610

Mailing address

PO Box 1750
Anasco, PR 00610-1750
Phone (787) 370-6187

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
I20110708000520 PR Practitioner - General Practice 8527246859 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17640PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dmra LLC General Practice CurrentSince Mar 2, 2013 Accepting new patients
Centro de Vacunacion de la Policlinica de Anasco PastSince Jan 28, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1518197136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1750",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006101750",
            "telephone_number": "787-370-6187",
            "fax_number": "787-826-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 DE INFANTERIA 67",
            "address_2": "SUITE 104-109",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "00610",
            "telephone_number": "787-826-2145",
            "fax_number": "787-826-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA RIOS",
        "first_name": "ROBERTO",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anasco, PR

Sources for this page

Verify at the official NPI Registry.