Active NPI
Luis Antonio Oliver, M.D.
- Pediatrics Physician
- San Juan, PR
National Provider Identifier
1760468433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 3686
- Practice address
- 402 Munoz Rivera Ave.
Basic Medical Clinic
San Juan, PR 00917 - Phone
- (787) 767-3636
- NPI assigned
- Dec 15, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 3686 | PR | Primary |
Addresses
Primary practice location
402 Munoz Rivera Ave.
Basic Medical Clinic
San Juan, PR 00917
Mailing address
1804 Calle Jajome
Urb. Crown Hills
San Juan, PR 00926-6024
Phone (787) 763-0077
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160720002487 | PR | Order and Referring Only - Pediatric Medicine | 8325331804 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3686 | PR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1760468433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 CALLE JAJOME",
"address_2": "URB. CROWN HILLS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009266024",
"telephone_number": "787-763-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 MUNOZ RIVERA AVE.",
"address_2": "BASIC MEDICAL CLINIC",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00917",
"telephone_number": "787-767-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "LUIS",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "3686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.