OMAR CANDELARIO VALDIVIESO LND
NPI 1174143317
Nutritionist - Nutrition, Education in Guayama, PR
About Omar Candelario Valdivieso Lnd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OMAR CANDELARIO VALDIVIESO LND (NPI 1174143317) is an individual nutrition, education provider in Guayama, Puerto Rico, licensed in Puerto Rico (2060) and active in the NPI registry since April 2020.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Omar Candelario Valdivieso Lnd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Omar Candelario Valdivieso reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Guayama, PR 00785
- Reassigned Medicare billing, Puerto Rico enrollment
- 17 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Omar Candelario Valdivieso's NPI number?
The NPI number for Omar Candelario Valdivieso is 1174143317. It was assigned to this individual provider in the NPPES registry on April 17, 2020.
Where is Omar Candelario Valdivieso located?
Omar Candelario Valdivieso practices at Urb. Guayama Valley Street 15 H-11, Guayama, PR 00785. The listed phone number is (787) 204-1036.
What is Omar Candelario Valdivieso's specialty?
The primary specialty registered for this NPI is Nutritionist, specializing in Nutrition, Education, with taxonomy code 133NN1002X.
Is Omar Candelario Valdivieso enrolled in Medicare?
Yes. Omar Candelario Valdivieso is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Omar Candelario Valdivieso's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Omar Candelario Valdivieso reassigns Medicare benefits to Hospital Menonita Guayama Inc (Guayama, PR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Omar Candelario Valdivieso's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Omar Candelario Valdivieso was last updated on April 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Omar Candelario Valdivieso, LND · NPI 1174143317
Nutrition, Education provider in Guayama, Puerto Rico. Individual provider, active in the CMS NPPES registry since April 17, 2020.
## Identity
- **NPI:** 1174143317 (Entity type: Individual)
- **Enumerated:** April 17, 2020
- **Primary specialty:** Nutritionist - Nutrition, Education · taxonomy 133NN1002X
- **State license:** 2060 (Puerto Rico)
- **Sole proprietor:** Yes
## Practice location
- **Address:** URB. GUAYAMA VALLEY STREET 15 H-11, Guayama, PR 00785
- **Phone:** (787) 204-1036
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Hospital Menonita Guayama Inc (NPI 1487246807, Guayama, PR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 17, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1174143317) · Data from the CMS NPPES public registry.