Individual provider Active NPI

Stefanny Santana Rivera, MD

  • Family Medicine Physician
  • Union, KY
National Provider Identifier
1104446020
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
61226 Issued in KY
Practice address
605 Man O War Boulevard
Union, KY 41091-2007
Phone
(859) 578-5333
NPI assigned
Apr 21, 2020
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.148517 OH
Family Medicine Physician 207Q00000X 61226 KY Primary

Addresses

Primary practice location

605 Man O War Boulevard
Union, KY 41091-2007

Mailing address

P.O. Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Other practice location 1

7642 Reading Rd
Cincinnati, OH 45237-3204
Phone (513) 619-7766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 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
I20230607000394 OH Practitioner - Family Practice 5597122580 Reassigns benefits to 1 organization
I20251205001840 KY Practitioner - Family Practice 5597122580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

605 Man O War Boulevard
Union, KY 41091-2007
Phone (859) 578-5669

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61226KYMDFamily Medicine Physician
35.148517OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Dec 29, 2025 Accepting new patients
Madeline Health Services LLC Family Medicine Current Accepting new patients
Dedicated Ohio Holding, LLC CurrentSince Jun 4, 2023 Accepting new patients
Summit Medical Group, Inc Family Medicine CurrentSince Dec 29, 2025 Accepting new patients
Dedicated Ohio Holding LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1360 Dolwick Dr
Erlanger, KY 41018
Phone (800) 737-7900

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

605 Man O War Blvd
Union, KY 41091
Phone (859) 578-5333

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

6121 Colerain Ave
Cincinnati, OH 45239
Phone (513) 354-2466

7642 Reading Rd
Cincinnati, OH 45237
Phone (513) 208-2880

Interoperability endpoints

  • Direct secure messaging: stefanny.santana.rivera.1@33344.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1104446020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MAN O WAR BOULEVARD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410912007",
            "telephone_number": "859-578-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7642 Reading Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452373204",
            "country_code": "US",
            "telephone_number": "513-619-7766",
            "fax_number": "513-810-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTANA RIVERA",
        "first_name": "STEFANNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.148517",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "61226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.