NPIMap

Individual provider Active NPI

Edmundo Rivera, MD

  • Surgery Physician
  • Lincoln, NE
National Provider Identifier
1033367206
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28645 Issued in NE
Practice address
4740 A St
Suite 100
Lincoln, NE 68510-4824
Phone
(402) 483-7825
Fax
(402) 483-7839
NPI assigned
Aug 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28645 NE Primary

Addresses

Primary practice location

4740 A St
Suite 100
Lincoln, NE 68510-4824

Mailing address

4740 A St
Suite 100
Lincoln, NE 68510-4824
Phone (402) 483-7825

Other identifiers 1

IdentifierTypeStateIssuer
47059807113MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804006110 NE Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7517108228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Creighton University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Surgical Group PCGroup PAC ID 3375512775, 4 clinicians

Practice addresses (Care Compare)

575 S 70TH St
Suite 405
Lincoln, NE 68510-2471
Phone (402) 483-7825

Hospital & facility affiliations

  • CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
  • CHI Health St Mary'S Hospital, Nebraska City, NE, CCN 281342
  • Thayer County Health Services Hospital, Hebron, NE, CCN 281304
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
70.13

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as apm
Quality
82.13
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue376
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28645NEMDSurgery Physician

Practice roles (2 of 8)

OrganizationSpecialtyStatusNew patients
Lincoln Surgical Group PC Surgery CurrentSince Aug 1, 2015 Accepting new patients
Saint Elizabeth Regional Medical Center Past Accepting new patients

Locations

575 S 70th St
Ste 405
Lincoln, NE 68510
Phone (402) 219-8005

4740 A St
Ste 100
Lincoln, NE 68510
Phone (402) 483-7825

Networks

  • CO HMO C-SNP
  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • IA HMO
  • CO HMO D-SNP
  • IA HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: edmundo.rivera@lsgp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFBAAA/Endpoint/CFBAAA

Organizations & group practices 2

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 6

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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1033367206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 A ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104824",
            "telephone_number": "402-483-7825",
            "fax_number": "402-483-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 A ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104824",
            "telephone_number": "402-483-7825",
            "fax_number": "402-483-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EDMUNDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "28645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47059807113",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.