Active NPI
Martin Rivera
- Clinical Social Worker
- Ponce, PR
National Provider Identifier
1891190294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18099
- Practice address
- 166 6 Street
Jaime L Drew
Ponce, PR 00730-1533 - Phone
- (787) 509-0774
- NPI assigned
- Oct 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18099 | PR | Primary |
Addresses
Primary practice location
166 6 Street
Jaime L Drew
Ponce, PR 00730-1533
Mailing address
166 6St
Jaime L Drew
Ponce, PR 00730-1533
Phone (787) 509-0774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18099 | PR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1891190294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 6ST",
"address_2": "JAIME L DREW",
"city": "PONCE",
"state": "PR",
"postal_code": "007301533",
"telephone_number": "787-509-0774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 6 STREET",
"address_2": "JAIME L DREW",
"city": "PONCE",
"state": "PR",
"postal_code": "007301533",
"telephone_number": "787-509-0774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MARTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-28",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "18099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.