Rafael Rios Rivera, M.D.
NPI 1366891590 · Rheumatology Physician · Ponce, PR
Enrolled with Medicare as Practitioner - Rheumatology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Rafael Rios Rivera, M.D. is a Rheumatology Physician provider in Ponce, PR (NPI 1366891590).
Provider details
- NPI number
- 1366891590
- Entity type
- Individual
- Primary specialty
- Rheumatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 21761 (PR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
10 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
20 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 20 | $86 |
Typical Medicare-allowed amounts for these services range $86–$86 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 34 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Methotrexate Sodiumbrand: Methotrexate | 335 | 56 |
| Prednisone | 293 | 80 |
| Gabapentin | 223 | 63 |
| Meloxicam | 173 | 67 |
| Baclofen | 137 | 53 |
| Hydroxychloroquine Sulfate | 137 | 38 |
| Alendronate Sodium | 104 | 24 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$2,253 across 19 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Mailing address
Registry dates
- Enumerated
- 2016-06-08
- Last updated
- 2023-09-11
- Certified
- 2023-09-11
Frequently asked questions
- What is Rafael Rios Rivera's NPI number?
- Rafael Rios Rivera's National Provider Identifier (NPI) is 1366891590, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Rafael Rios Rivera's specialty?
- Rafael Rios Rivera is listed in the NPPES registry with a primary specialty of Rheumatology Physician (Allopathic & Osteopathic Physicians).
- Where is Rafael Rios Rivera located?
- Rafael Rios Rivera's practice location on file with NPPES is 1010 Paseo Del Veterano, Ponce, PR 00716-2001.
- What is Rafael Rios Rivera's phone number?
- The practice phone number listed in the NPPES registry for Rafael Rios Rivera is (787) 492-0112.
- Does Rafael Rios Rivera accept Medicare?
- Rafael Rios Rivera is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Rafael Rios Rivera's NPI active?
- Yes — Rafael Rios Rivera's NPI (1366891590) is active in the NPPES registry as of the last update on 2023-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.