Individual provider Active NPI

Wyatt Harlan Rivas, M.D.

  • Emergency Medicine Physician
  • Yakima, WA
National Provider Identifier
1083889737
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60215678 Issued in WA
Practice address
2811 Tieton Dr
Yakima, WA 98902-3761
Phone
(509) 575-8000
Fax
(509) 575-8745
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60215678 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2811 Tieton Dr
Yakima, WA 98902-3761

Mailing address

PO Box 9787
Yakima, WA 98909-0787
Phone (509) 575-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20111220000124 WA Practitioner - Emergency Medicine 8921273012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital District No. 2, Klickitat County, WashingtonGroup PAC ID 4981592144, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

211 NE Skyline Dr
White Salmon, WA 98672-1948
Phone (509) 493-1101

Hospital & facility affiliations

  • Skyline Hospital Hospital, White Salmon, WA, CCN 501315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60215678WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Apr 19, 2022 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington CurrentSince Jul 1, 2025 Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Apr 19, 2022 Accepting new patients
Yakima Valley Memorial Physicians PastSince Aug 2, 2020 Accepting new patients

Locations

212 NE Skyline Dr
White Salmon, WA 98672
Phone (509) 493-2133

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

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 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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1083889737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9787",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989090787",
            "telephone_number": "509-575-8255",
            "fax_number": "509-225-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8000",
            "fax_number": "509-575-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "WYATT",
        "middle_name": "HARLAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60215678",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.