Individual provider Active NPI

Myriam Maldonado Rivera, M.D.

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1578572319
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14247 Issued in PR
Practice address
Aq35 Ave Laurel
Santa Juanita
Bayamon, PR 00956-4725
Phone
(787) 995-0445
Fax
(787) 995-0445
NPI assigned
Aug 7, 2006
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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 14247 PR Primary

Addresses

Primary practice location

Aq35 Ave Laurel
Santa Juanita
Bayamon, PR 00956-4725

Mailing address

Aq35 Ave Laurel
Santa Juanita
Bayamon, PR 00956-4725
Phone (787) 995-0445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14247PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratorio Clinico Y Bacteriologico Laurel 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, 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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1578572319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AQ35 AVE LAUREL",
            "address_2": "SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564725",
            "telephone_number": "787-995-0445",
            "fax_number": "787-995-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AQ35 AVE LAUREL",
            "address_2": "SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564725",
            "telephone_number": "787-995-0445",
            "fax_number": "787-995-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO RIVERA",
        "first_name": "MYRIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.