Individual provider Active NPI

Regina Shea Dalla Riva

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1104211416
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
66402-20 Issued in WI
Practice address
6940 Michigan Rd Ste 140
Indianapolis, IN 46268-2800
Phone
(317) 266-2901
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 66402-20 WI Primary

Addresses

Primary practice location

6940 Michigan Rd Ste 140
Indianapolis, IN 46268-2800

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other practice location 1

4855 S Moorland Rd
New Berlin, WI 53151-7494
Phone (262) 432-7599

Other practice location 2

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-7494
Phone (414) 672-1353

Other identifiers 1

IdentifierTypeStateIssuer
1104211416MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdallariva131068@direct.eskenazihealth.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IN2 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
I20240329000328 WI Practitioner - Pediatric Medicine 0648542241 Reassigns benefits to 1 organization
I20240716003158 IN Practitioner - Pediatric Medicine 0648542241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66402-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Health and Hospital Corporation of Marion County CurrentSince Sep 3, 2024 Accepting new patients
Sixteenth Street Community Health Centers, Inc. Pediatrics CurrentSince Mar 15, 2024 Accepting new patients
16TH Street Community Health Center Inc. Pediatrics Current Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Sep 3, 2024 Accepting new patients
16TH Street Community Health Center Inc. Pediatrics CurrentSince Mar 15, 2024 Accepting new patients

Locations

1660 N Illinois St
Indianapolis, IN 46202
Phone (317) 880-2900

720 Eskenazi Ave
Bldg 5TH
Indianapolis, IN 46202
Phone (317) 880-3818

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

5525 W 34th St
Indianapolis, IN 46224
Phone (317) 848-7368

1112 Southeastern Ave
Indianapolis, IN 46202
Phone (317) 423-8909

2700 Martin Luther King Jr St
Indianapolis, IN 46208
Phone (317) 931-4300

9443 E 38th St
Indianapolis, IN 46235
Phone (317) 890-2100

6940 Michigan Rd
Ste 140
Indianapolis, IN 46268
Phone (317) 266-2901

3010 N White River Parkway East Dr
Indianapolis, IN 46208
Phone (317) 880-3535

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

1337 S Cesar E Chavez Dr
Milwaukee, WI 53204
Phone (414) 672-1354

Interoperability endpoints

  • Direct secure messaging: rdallariva361801@direct.ochin.org
  • Direct secure messaging: rdallariva131068@direct.eskenazihealth.edu

Organizations & group practices 5

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1104211416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 MICHIGAN RD STE 140",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462682800",
            "telephone_number": "317-266-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4855 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517494",
            "country_code": "US",
            "telephone_number": "262-432-7599",
            "fax_number": "262-432-7694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1032 S Cesar E Chavez Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532047494",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLA RIVA",
        "first_name": "REGINA",
        "middle_name": "SHEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "66402-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104211416",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdallariva131068@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "6940 Michigan Rd Ste 140",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462682800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.