Individual provider Active NPI

Rafael Rivera Aviles

  • Psychologist
  • San Juan, PR
National Provider Identifier
1811444938
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5715 Issued in PR
Practice address
G10 Calle 4
Dos Pinos Town House
San Juan, PR 00923
Phone
(787) 923-9222
NPI assigned
Sep 7, 2016
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5715 PR Primary

Addresses

Primary practice location

G10 Calle 4
Dos Pinos Town House
San Juan, PR 00923

Mailing address

G10 Calle 4
Dos Pinos Town House
San Juan, PR 00923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208002332 PR Practitioner - Psychologist Billing Independently 5799128575 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5715PRMDPsychologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1811444938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G10 CALLE 4",
            "address_2": "DOS PINOS TOWN HOUSE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G10 CALLE 4",
            "address_2": "DOS PINOS TOWN HOUSE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00923",
            "telephone_number": "787-923-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA AVILES",
        "first_name": "RAFAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "5715",
            "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 Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.