Individual provider Active NPI

Glorimar Medina-Rivera, M.D.

  • Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1043426570
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M5372 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-6200
Fax
(713) 500-6201
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X M5372 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

PO Box 301173
Dallas, TX 75303-1173
Phone (713) 500-3500

Other identifiers 4

IdentifierTypeStateIssuer
8AG240OtherTXBCBS
185858101MedicaidTX
8BC111OtherTXBCBS
185858102OtherTXCSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000638 TX Practitioner - Anesthesiology 5092806398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Mar 1, 2012 Accepting new patients
Ut Physicians Anesthesiology CurrentSince Mar 1, 2012 Accepting new patients
Ut Physicians Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste 470
Houston, TX 77030
Phone (713) 500-3561

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

5550 Kelley St
Fl 3
Houston, TX 77026
Phone (713) 566-4768

5656 Kelley St
#3
Houston, TX 77026
Phone (713) 566-5098

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 510
Houston, TX 77030
Phone (713) 500-5736

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1043426570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031173",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6200",
            "fax_number": "713-500-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-RIVERA",
        "first_name": "GLORIMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M5372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AG240",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185858101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BC111",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "185858102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.