Ricardo A Nieves, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

40977 Issued in CO

Practice address

1437 Riverside Ave
Fort Collins, CO 80524-4324

Phone

(970) 692-5550

Fax

(970) 692-5561

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Independent Anesthesiologists, PLLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1841614674
  NPD (past)
• Spine Technology and Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Angola, IN
  • NPI 1154304186
  NPD (past)
• Spine Technology and Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Fort Wayne, IN
  • NPI 1245213263

  Interventional Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1003909276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244324",
            "telephone_number": "970-692-5550",
            "fax_number": "970-692-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244324",
            "telephone_number": "970-692-5550",
            "fax_number": "970-692-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "RICARDO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NM",
            "license": "2000325",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CO",
            "license": "40977",
            "primary": true
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "CO",
            "license": "40977",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04732863",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B9615",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Jo Nielsen, MS, RD, CDE
• Lani D Nielsen, CNM
• Stephanie Stariha Nielsen, DDS
• Rebecca Elizabeth Niesent
• Emma Nieters
• Laurie Niles, DNP
• Kristi Nissen
• Megan Nix
• Kent Wilkinson Nixon, D.O.M., L.AC.
• Laci Jane Nixon

• All providers in Fort Collins, CO
• Interventional Pain Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.