Active NPI
Carlos M Rivera, PHYSICIAN ASSISTANT
- Physician Assistant
- Mayaguez, PR
National Provider Identifier
1699516062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 826-P.A
- Practice address
- 75 Calle Simon Bolivar
Mayaguez, PR 00680-4506 - Phone
- (939) 228-4771
- NPI assigned
- Jun 1, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 826-P.A | PR | Primary |
Addresses
Primary practice location
75 Calle Simon Bolivar
Mayaguez, PR 00680-4506
Mailing address
747 Island St
Davenport, FL 33897-5836
Phone (939) 228-4771
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 826-P.A | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717200000000",
"number": "1699516062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 ISLAND ST",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338975836",
"telephone_number": "939-228-4771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 CALLE SIMON BOLIVAR",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006804506",
"telephone_number": "939-228-4771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "CARLOS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-01",
"last_updated": "2024-06-01",
"certification_date": "2024-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "826-P.A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayaguez, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.