NPIMap

Individual provider Active NPI

Kelvin Xavier Rivera Manzano, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • San Jaun, PR
National Provider Identifier
1619226578
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
19015 Issued in PR
Practice address
San Juan City Hospital
PMB # 79
San Jaun, PR 00936
Phone
(787) 480-2700
NPI assigned
Sep 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19015 PR
Pulmonary Disease Physician 207RP1001X 19015 PR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 19015 PR Primary

Addresses

Primary practice location

San Juan City Hospital
PMB # 79
San Jaun, PR 00936

Mailing address

Madrigal 194
Urb. la Serrania
Caguas, PR 00725
Phone (787) 360-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718000856 PR Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 8022343664 Reassigns benefits to 4 organizations
Practice locations: Bayamon, PR; Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Recinto de Ciencias MedicasGroup PAC ID 3678469962, 246 clinicians

Practice addresses (Care Compare)

Centro Medico de Puerto Rico Bo Mona
Hospital Universitario de Adultos
Rio Piedras, PR 00935
Phone (787) 754-0101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19015PRMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas CurrentSince Jul 1, 2023 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Sep 1, 2019 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Sep 1, 2019 Accepting new patients
Recinto de Ciencias Medicas Critical Care Medicine CurrentSince Jul 1, 2023 Accepting new patients
Centro de Cancer de la Universidad Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Neurocritical Care Physician CurrentSince Nov 6, 2023 Accepting new patients
Departamento de Salud Oficial Past Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Centro Medico De Puerto Ri
San Juan, PR 00935

Centro Medico De Puerto Rico Bo Monacillos
San Juan, PR 00935

Organizations & group practices 7

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1619226578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADRIGAL 194",
            "address_2": "URB. LA SERRANIA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-360-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN JUAN CITY HOSPITAL",
            "address_2": "PMB # 79",
            "city": "SAN JAUN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-480-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA MANZANO",
        "first_name": "KELVIN",
        "middle_name": "XAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19015",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PR",
            "license": "19015",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PR",
            "license": "19015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jaun, PR

Sources for this page

Verify at the official NPI Registry.