Individual provider Active NPI

Reivan Buenaobra, RN

  • Urology Registered Nurse
  • Fresno, CA
National Provider Identifier
1013868629
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology Registered NurseTaxonomy code 163WU0100X
License
R221695 Issued in MD
Practice address
2615 E Clinton Ave
Fresno, CA 93703-2223
Phone
(559) 228-5371
NPI assigned
Feb 9, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WU0100X R221695 MD Primary

Addresses

Primary practice location

2615 E Clinton Ave
Fresno, CA 93703-2223

Mailing address

2615 E Clinton Ave
Fresno, CA 93703-2223
Phone (559) 228-5371

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R221695MDMDUrology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1013868629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032223",
            "telephone_number": "559-228-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032223",
            "telephone_number": "559-228-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENAOBRA",
        "first_name": "REIVAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WU0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Urology",
            "state": "MD",
            "license": "R221695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.