Individual provider Active NPI

Benjamin Miranda Rivera, MD

  • General Practice Physician
  • Santurce, PR
National Provider Identifier
1548325947
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7660 Issued in PR
Practice address
1826 Ave Fernandez Juncos
Santurce, PR 00909-3004
Phone
(787) 726-8396
NPI assigned
Dec 26, 2006
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 7660 PR Primary

Addresses

Primary practice location

1826 Ave Fernandez Juncos
Santurce, PR 00909-3004

Mailing address

45 Calle Tenerife
Palmas del Turabo
Caguas, PR 00727-6769
Phone (787) 286-2806

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
I20130802000650 PR Practitioner - General Practice 2062653041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1980
Medicare assignment
May accept Medicare assignment
Group practices
Tiger Med CorpGroup PAC ID 3476707258, 13 clinicians

Practice addresses (Care Compare)

3 Calle Munoz Rivera
Caguas, PR 00725-2602
Phone (787) 286-2800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7660PRMDGeneral Practice Physician

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, 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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1548325947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CALLE TENERIFE",
            "address_2": "PALMAS DEL TURABO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007276769",
            "telephone_number": "787-286-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 AVE FERNANDEZ JUNCOS",
            "city": "SANTURCE",
            "state": "PR",
            "postal_code": "009093004",
            "telephone_number": "787-726-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA RIVERA",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "7660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santurce, PR

Sources for this page

Verify at the official NPI Registry.