Individual provider Active NPI

Pedro F Moreno Rivera

  • General Practice Physician
  • Coamo, PR
National Provider Identifier
1639848625
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24627 Issued in PR
Practice address
Urb Las Aguilas 8TH Street I 23
Coamo, PR 00769-3514
Phone
(787) 900-5459
NPI assigned
Sep 13, 2021
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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 24627 PR Primary

Addresses

Primary practice location

Urb Las Aguilas 8TH Street I 23
Coamo, PR 00769-3514

Mailing address

Urb Las Aguilas 8TH Street I 23
Coamo, PR 00769-3514
Phone (787) 900-5459

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
I20251125003161 PR Practitioner - General Practice 6103318233 Reassigns benefits to 2 organizations
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

371 Calle Jose de Diego
San Juan, PR 00923-3002
Phone (787) 767-5100

500 Condominio Elmaria
Camino Los Pizarros Apartado 29
San Juan, PR 00926-7237

HC 02 Box
Arecibo, PR 00612

PO Box
Suite 1650
Cidra, PR 00739

PO Box
Suite 1650
Cidra, PR 00739-1650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24627PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc CurrentSince Dec 9, 2025 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Dec 9, 2025 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1639848625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB LAS AGUILAS 8TH STREET I 23",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007693514",
            "telephone_number": "787-900-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB LAS AGUILAS 8TH STREET I 23",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007693514",
            "telephone_number": "787-900-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO RIVERA",
        "first_name": "PEDRO F",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

Verify at the official NPI Registry.