NPIMap

Individual provider Active NPI

Daniel Rivera, DO

  • Surgery Physician
  • Boise, ID
National Provider Identifier
1164912507
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
O-2014 Issued in ID
Practice address
999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone
(208) 302-2600
Fax
(208) 302-2625
NPI assigned
May 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101023796 MI
Surgery Physician 208600000X O-2014 ID Primary

Addresses

Primary practice location

999 N Curtis Rd Ste 415
Boise, ID 83706-1334

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240705002821 ID Practitioner - General Surgery 4082952957 Reassigns benefits to 1 organization
I20240803000129 GA Practitioner - General Surgery 4082952957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

999 N Curtis Rd
Suite 415
Boise, ID 83706-1334
Phone (208) 302-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-2014IDMDSurgery Physician
5101023796MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Aug 1, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Aug 1, 2024 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2024 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Saint Alphonsus Specialty Services Inc Surgery PastSince Jun 23, 2024 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

999 N Curtis Rd
Ste 415
Boise, ID 83706
Phone (208) 302-2600

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: drivera3494918@direct.trinity-health.org
  • Direct secure messaging: drivera536445@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1164912507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N CURTIS RD STE 415",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061334",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-606-5981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101023796",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.