Individual provider Active NPI

Jason Rivera, FNP

  • Family Nurse Practitioner
  • Laredo, TX
National Provider Identifier
1114560950
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1126707 Issued in TX
Practice address
1419 Clark Blvd
Laredo, TX 78040-3417
Phone
(956) 723-0039
NPI assigned
Oct 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1126707 TX Primary

Addresses

Primary practice location

1419 Clark Blvd
Laredo, TX 78040-3417

Mailing address

228 Sevilla Loop
Laredo, TX 78043-4152
Phone (956) 307-0318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250617000817 TX Practitioner - Nurse Practitioner 6507377579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1126707TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norberto Alvarez, Jr.,M.D.,PA CurrentSince May 12, 2025 Accepting new patients

Locations

1710 E Saunders St
Ste B460
Laredo, TX 78041
Phone (956) 794-8720

1419 Clark Blvd
Laredo, TX 78040
Phone (956) 723-0039

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBGHAA/Endpoint/DBGHAA

Organizations & group practices 1

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1114560950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 SEVILLA LOOP",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434152",
            "telephone_number": "956-307-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 CLARK BLVD",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780403417",
            "telephone_number": "956-723-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JASON",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-24",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1126707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.