Individual provider Active NPI

Rafael A Cepeda Lara, MD

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1790779395
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7041 Issued in PR
Practice address
Ave. Rio Bayamon Za-1 BLQ. 36
Urb. Riverview
Bayamon, PR 00961
Phone
(787) 785-2694
Fax
(787) 787-3109
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 7041 PR Primary

Addresses

Primary practice location

Ave. Rio Bayamon Za-1 BLQ. 36
Urb. Riverview
Bayamon, PR 00961

Mailing address

PO Box 51613
Toa Baja, PR 00950-1613
Phone (787) 786-4192

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
I20050906001026 PR Practitioner - General Practice 6709818230 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Za1 Calle
Suite 36
Bayamon, PR 00961-3929
Phone (787) 785-2694

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7041PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Medical Services, Inc. General Practice Past Accepting new patients
Riverview Cardiovascular Services CSP 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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790779395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51613",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009501613",
            "telephone_number": "787-786-4192",
            "fax_number": "787-787-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. RIO BAYAMON ZA-1 BLQ. 36",
            "address_2": "URB. RIVERVIEW",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-785-2694",
            "fax_number": "787-787-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPEDA LARA",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "7041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.