Individual provider Active NPI

Ada Iris Rivera, M.D.

  • Prison Health Clinic/Center
  • Guaynabo, PR
National Provider Identifier
1942419841
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
License
5888 Issued in PR
Practice address
652 Carretera 28
Metropolitan Detention Center
Guaynabo, PR 00962-5700
Phone
(787) 775-7927
Fax
(787) 775-7994
NPI assigned
May 21, 2007
Last updated
Mar 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X 5888 PR Primary
Internal Medicine Physician 207R00000X 5888 PR

Addresses

Primary practice location

652 Carretera 28
Metropolitan Detention Center
Guaynabo, PR 00962-5700

Mailing address

RR 3 Box 7289
La Peninsula
Cidra, PR 00739-9346
Phone (787) 775-7927

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5888PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1942419841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 7289",
            "address_2": "LA PENINSULA",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399346",
            "telephone_number": "787-775-7927",
            "fax_number": "787-775-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 CARRETERA 28",
            "address_2": "METROPOLITAN DETENTION CENTER",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009625700",
            "telephone_number": "787-775-7927",
            "fax_number": "787-775-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ADA",
        "middle_name": "IRIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "PR",
            "license": "5888",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "5888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.