Individual provider Active NPI

Jose Antonio Rivera Valles, M.D.

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1861573677
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14709 Issued in PR
Practice address
Ave Americo Miranda Esq Centro Medico
San Juan, PR 00935-0001
Phone
(787) 420-6331
Fax
(939) 336-9598
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14709 PR Primary

Addresses

Primary practice location

Ave Americo Miranda Esq Centro Medico
San Juan, PR 00935-0001

Mailing address

PO Box 194535
San Juan, PR 00919-4535
Phone (787) 420-6331

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
I20080710000195 PR Practitioner - Internal Medicine 6800968710 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR; San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ave Americo Miranda
Esquina Centro Medico
San Juan, PR 00935-0001
Phone (787) 754-8500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14709PRMDInternal Medicine Physician

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1861573677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194535",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194535",
            "telephone_number": "787-420-6331",
            "fax_number": "787-799-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE AMERICO MIRANDA ESQ CENTRO MEDICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-420-6331",
            "fax_number": "939-336-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA VALLES",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "14709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.