Individual provider Active NPI

Andrew Vincent Rives, PA-C

  • Medical Physician Assistant
  • Redlands, CA
National Provider Identifier
1023487006
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
52824 Issued in CA
Practice address
1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704
Phone
(909) 557-1600
NPI assigned
Sep 18, 2015
Last updated
Sep 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 52824 CA Primary
Surgical Physician Assistant 363AS0400X 52824 CA

Addresses

Primary practice location

1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704

Mailing address

1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704
Phone (909) 557-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109002356 CA Practitioner - Physician Assistant 2062722754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1901 W Lugonia Ave
Redlands, CA 92374-9703
Phone (909) 557-1600

4234 Riverwalk Pkwy
Suite 200
Riverside, CA 92505-3312
Phone (951) 977-2500

8805 Haven Ave
Suite 100110
Rancho Cucamonga, CA 91730-5149
Phone (909) 557-1600

8805 Haven Ave
Suite 200
Rancho Cucamonga, CA 91730-5157
Phone (909) 912-1750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52824CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 1, 2015 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Redlands Community Hospital Past Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Past Accepting new patients
Hi-Desert Medical Center Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. PastSince Oct 25, 2020 Accepting new patients

Locations

15325 Fairfield Ranch Rd
Ste 150
Chino Hills, CA 91709
Phone (909) 557-1668

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

8805 Haven Ave
Ste 100
Rancho Cucamonga, CA 91730
Phone (909) 912-1750

8805 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 912-1750

1801 Orange Tree Ln
Ste 240
Redlands, CA 92374

1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

4234 Riverwalk Pkwy
Ste 200
Riverside, CA 92505
Phone (951) 977-2500

2131 Elks Dr
Ste 200
San Bernardino, CA 92404
Phone (909) 726-6100

15095 Amargosa Rd
Ste 106
Victorville, CA 92394
Phone (760) 245-6495

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1023487006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 120",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749704",
            "telephone_number": "909-557-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 120",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749704",
            "telephone_number": "909-557-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVES",
        "first_name": "ANDREW",
        "middle_name": "VINCENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52824",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "52824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.