Individual provider Active NPI

Samuel Eduardo Rivera, M.D.

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1124164892
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0763 Issued in TX
Practice address
701 S Zarzamora St
San Antonio, TX 78207-5209
Phone
(210) 358-7474
Fax
(210) 358-7406
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0763 TX Primary

Addresses

Primary practice location

701 S Zarzamora St
San Antonio, TX 78207-5209

Mailing address

PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9172

Other names 1

  • Dr. Samuel Eduardo Rivera-Flores Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804000353 TX Practitioner - Internal Medicine 3274563390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0763TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
St Davids Heart & Vascular, PLLC Past Accepting new patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients

Locations

701 S Zarzamora St
San Antonio, TX 78207
Phone (210) 358-7000

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

Organizations & group practices 3

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1124164892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9172",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075209",
            "telephone_number": "210-358-7474",
            "fax_number": "210-358-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SAMUEL",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H0763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "RIVERA-FLORES",
            "middle_name": "EDUARDO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.