Active NPI
Pedro Juan Rivera, M.D.
- Ophthalmology Physician
- Durham, NC
National Provider Identifier
1164554671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Practice address
- 2100 Erwin Rd
Durham, NC 27710-0001 - Phone
- (919) 684-8111
- NPI assigned
- Mar 10, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD - 199903 | LA | |
| Ophthalmology Physician | 207W00000X | NC | Primary |
Addresses
Primary practice location
2100 Erwin Rd
Durham, NC 27710-0001
Mailing address
4101 N Roxboro St
Durham, NC 27704-2121
Phone (919) 684-8111
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD - 199903 | LA | MD | Ophthalmology Physician |
| 2007-00445 | NC | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1164554671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042121",
"telephone_number": "919-684-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-684-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "PEDRO",
"middle_name": "JUAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-10",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "LA",
"license": "MD - 199903",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.