Individual provider Active NPI

Victor Ivan Rivera, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1023675527
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD476805 Issued in PA
Practice address
1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone
(215) 955-6864
NPI assigned
May 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD476805 PA Primary

Addresses

Primary practice location

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005

Mailing address

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone (215) 955-6864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241023000173 PA Practitioner - Diagnostic Radiology 9830423367 Reassigns benefits to 1 organization
I20250609002562 NY Practitioner - Interventional Radiology 9830423367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Temple University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.55 of 100Reported as apm
Quality
83.57
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 1, 2024 Accepting new patients
Methodist Associates in Healthcare, Inc Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Aug 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1421 3rd Ave
New York, NY 10028
Phone (212) 744-5538

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

111 S 11th St
Ste G3390
Philadelphia, PA 19107
Phone (215) 955-2900

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: vrivera327335@northwell.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1023675527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "VICTOR",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD476805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.