Individual provider Active NPI

Fernando Rivero, PA, MPAS, MPH

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1063992022
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10953254-1206 Issued in UT
Practice address
201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692
Phone
(801) 543-6872
NPI assigned
Aug 20, 2018
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10953254-1206 UT Primary

Addresses

Primary practice location

201 W Layton Pkwy Ste 1a
Layton, UT 84041-3692

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

380 W 100 N Ste A
Monticello, UT 84535-7879
Phone (435) 587-5054

Other practice location 2

5555 S Old Airport Rd
Moab, UT 84532
Phone (435) 419-9210

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20190506002730 UT Practitioner - Physician Assistant 4587906805 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians
San Juan County HospitalGroup PAC ID 4486541851, 19 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195

4403 Harrison Blvd
Suite 2600
Ogden, UT 84403-3277
Phone (801) 378-7450

5555 Old Airport Rd
Spanish Valley, UT 84532-5105
Phone (435) 587-1234

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10953254-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan County Hospital CurrentSince Nov 1, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 2, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 24, 2025 Accepting new patients
San Juan County Hospital CurrentSince Nov 1, 2021 Accepting new patients
San Juan County Hospital Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

735 S 200 W
Ste 3
Blanding, UT 84511
Phone (435) 678-2254

5555 Old Airport Rd
Moab, UT 84532
Phone (435) 419-9210

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/

Organizations & group practices 10

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1063992022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LAYTON PKWY STE 1A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413692",
            "telephone_number": "801-543-6872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 W 100 N Ste A",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "UT",
            "postal_code": "845357879",
            "country_code": "US",
            "telephone_number": "435-587-5054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 S Old Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Moab",
            "state": "UT",
            "postal_code": "84532",
            "country_code": "US",
            "telephone_number": "435-419-9210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "FERNANDO",
        "credential": "PA, MPAS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10953254-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.