Individual provider Active NPI

Nelki Brunilda Rivera Acosta, MD

  • Family Medicine Physician
  • Lares, PR
National Provider Identifier
1730601568
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21635 Issued in PR
Practice address
Carr #111 KM 1.9 Ave Los Patriotas
Lares, PR 00669
Phone
(787) 897-2727
Fax
(787) 897-2725
NPI assigned
Jul 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21635 PR Primary
Family Medicine Physician 207Q00000X ME146553 FL

Addresses

Primary practice location

Carr #111 KM 1.9 Ave Los Patriotas
Lares, PR 00669

Mailing address

76 Calle Manuel M Samas
Trastalleres
Mayaguez, PR 00682-5808
Phone (787) 673-4406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200727002825 FL Practitioner - Family Practice 9436573235 Reassigns benefits to 1 organization
I20230127002411 PR Practitioner - Family Practice 9436573235 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21635PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de Lares, Inc CurrentSince Dec 19, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC Current Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Aug 1, 2020 Accepting new patients
Centro de Salud de Lares, Inc CurrentSince Dec 19, 2022 Accepting new patients

Locations

3059 Edgewood Ave W
Jacksonville, FL 32209
Phone (904) 647-3180

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1730601568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 CALLE MANUEL M SAMAS",
            "address_2": "TRASTALLERES",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006825808",
            "telephone_number": "787-673-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #111 KM 1.9 AVE LOS PATRIOTAS",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA ACOSTA",
        "first_name": "NELKI",
        "middle_name": "BRUNILDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "21635",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME146553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.