Individual provider Active NPI

Emmanuel Rivera, M.D.

  • General Practice Physician
  • Humacao, PR
National Provider Identifier
1801297445
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
018882 Issued in PR
Practice address
Carr 925, KM 0.3
Bo. Junquito
Humacao, PR 00791
Phone
(787) 313-3043
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 018882 PR Primary

Addresses

Primary practice location

Carr 925, KM 0.3
Bo. Junquito
Humacao, PR 00791

Mailing address

HC 12 Box 5623
Humacao, PR 00791-9205
Phone (787) 313-3043

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
I20141121001938 PR Practitioner - General Practice 0042532343 Reassigns benefits to 1 organization
Practice locations: Aguas Buenas, PR; Cayey, PR; Cidra, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018882PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince Oct 14, 2014 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Oct 14, 2014 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1801297445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 12 BOX 5623",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007919205",
            "telephone_number": "787-313-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 925, KM 0.3",
            "address_2": "BO. JUNQUITO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-313-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "018882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.