Active NPI
Gerardo Rivera, 912
- Speech-Language Pathologist
- Juncos, PR
National Provider Identifier
1700241395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 912
- Practice address
- Carr 31 KM 22.4
Bo. Ceiba Norte
Juncos, PR 00777 - Phone
- (787) 679-6569
- Fax
- (939) 336-7250
- NPI assigned
- Dec 23, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 912 | PR | Primary |
Addresses
Primary practice location
Carr 31 KM 22.4
Bo. Ceiba Norte
Juncos, PR 00777
Mailing address
Cond. New San Juan
Apt 318 Ave Isla Verde
Carolina, PR 00979
Phone (787) 698-1217
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 |
|---|---|---|---|
| 912 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450828800000",
"number": "1700241395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "COND. NEW SAN JUAN",
"address_2": "APT 318 AVE ISLA VERDE",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00979",
"telephone_number": "787-698-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 31 KM 22.4",
"address_2": "BO. CEIBA NORTE",
"city": "JUNCOS",
"state": "PR",
"postal_code": "00777",
"telephone_number": "787-679-6569",
"fax_number": "939-336-7250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "GERARDO",
"credential": "912",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-23",
"last_updated": "2015-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PR",
"license": "912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Juncos, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.