Individual provider Active NPI

Daniel Rivera, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Kennett, MO
National Provider Identifier
1154465326
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2026013335 Issued in MO
Practice address
304 Teaco Rd
Kennett, MO 63857-3266
Phone
(316) 775-8404
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 39937 OK
Pain Medicine (Anesthesiology) Physician 207LP2900X 2026013335 MO Primary

Addresses

Primary practice location

304 Teaco Rd
Kennett, MO 63857-3266

Mailing address

304 Teaco Rd
Kennett, MO 63857-3266
Phone (316) 775-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK2 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
I20110211000460 MO Practitioner - Anesthesiology 7911187638 Reassigns benefits to 1 organization
I20220913003111 OK Practitioner - Anesthesiology 7911187638 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2026013335MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Oklahoma Anesthesia Consultants PLLC Anesthesiology CurrentSince Aug 30, 2022 Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC Anesthesiology CurrentSince Jan 19, 2023 Accepting new patients
Westport Anesthesia Services of Missouri, PC Anesthesiology Past Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

1710 W 3rd St
Ste 100
Elk City, OK 73644
Phone (580) 255-1555

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

Organizations & group practices 4

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1154465326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573266",
            "telephone_number": "316-775-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573266",
            "telephone_number": "316-775-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "39937",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2026013335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

Verify at the official NPI Registry.