Active NPI
Alexander Rivera
- Physician Assistant
- Bakersfield, CA
National Provider Identifier
1114357381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 55130
- Practice address
- 4601 Scalloway CT
Bakersfield, CA 93312-1945 - Phone
- (661) 343-1062
- NPI assigned
- Nov 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1115692 | TX | |
| Physician Assistant | 363A00000X | 55130 | CA | Primary |
Addresses
Primary practice location
4601 Scalloway CT
Bakersfield, CA 93312-1945
Mailing address
4601 Scalloway CT
Bakersfield, CA 93312-1945
Phone (661) 343-1062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1115692 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1114357381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 SCALLOWAY CT",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933121945",
"telephone_number": "661-343-1062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 SCALLOWAY CT",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933121945",
"telephone_number": "661-343-1062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "ALEXANDER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-25",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "1115692",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "55130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.