Individual provider Active NPI

Edward Nieves-Roman, M.D.

  • Internal Medicine Physician
  • Rio Grande, PR
National Provider Identifier
1669580635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8213 Issued in PR
Practice address
L2 Calle 6
Villas de Rio Grande
Rio Grande, PR 00745-2825
Phone
(787) 888-8888
Fax
(787) 888-8887
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8213 PR Primary

Addresses

Primary practice location

L2 Calle 6
Villas de Rio Grande
Rio Grande, PR 00745-2825

Mailing address

L2 Calle 6
Villas de Rio Grande
Rio Grande, PR 00745-2825
Phone (787) 888-8888

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
I20140106000999 PR Practitioner - Internal Medicine 4082842620 Practice locations: Fajardo, PR; Rio Grande, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Villas de Rio Grande
Rio Grande, PR 00745-2825

L2 Calle
Suite 6
Rio Grande, PR 00745-2825
Phone (787) 888-8888

Torre Hima San Pablo
Ave General Valero Suite 203
Fajardo, PR 00738-3988
Phone (787) 860-8886

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8213PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edniro Clinical Services PSC Internal Medicine Past Accepting new patients
Centro Clinico del Este, PSC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669580635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L2 CALLE 6",
            "address_2": "VILLAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007452825",
            "telephone_number": "787-888-8888",
            "fax_number": "787-888-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L2 CALLE 6",
            "address_2": "VILLAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007452825",
            "telephone_number": "787-888-8888",
            "fax_number": "787-888-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES-ROMAN",
        "first_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.