Individual provider Active NPI

Edgar Rivera Martinez, M.D.

  • General Practice Physician
  • Aibonito, PR
National Provider Identifier
1972576049
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15031 Issued in PR
Practice address
Calle Jose C Vazquez
Edificio Profesional Oficina 202 Hospital Menonita
Aibonito, PR 00705
Phone
(787) 735-7110
Fax
(787) 991-3041
NPI assigned
Feb 9, 2006
Last updated
Nov 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 15031 PR Primary

Addresses

Primary practice location

Calle Jose C Vazquez
Edificio Profesional Oficina 202 Hospital Menonita
Aibonito, PR 00705

Mailing address

PO Box 2300
PMB 21
Aibonito, PR 00705-2300
Phone (787) 735-7110

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
I20111207000767 PR Practitioner - General Practice 3870522543 Practice locations: Aibonito, PR

Care Compare profile

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

Practice addresses (Care Compare)

202 Edif Profesional Oficina
Aibonito, PR 00705
Phone (787) 735-7110

Edificio Profesional Oficina
202 Hospital Menonita
Aibonito, PR 00705

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15031PRMDGeneral Practice Physician

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1972576049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2300",
            "address_2": "PMB 21",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007052300",
            "telephone_number": "787-735-7110",
            "fax_number": "787-991-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE JOSE C VAZQUEZ",
            "address_2": "EDIFICIO PROFESIONAL OFICINA 202 HOSPITAL MENONITA",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-735-7110",
            "fax_number": "787-991-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA MARTINEZ",
        "first_name": "EDGAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.