NPIMap

Individual provider Active NPI

Kent Alan Rivas, DO

  • Internal Medicine Physician
  • Huntington, WV
National Provider Identifier
1174012611
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PENDING Issued in WV
Practice address
2900 1St Ave RM 1025
Huntington, WV 25702-1241
Phone
(304) 399-7484
Fax
(304) 399-7579
NPI assigned
May 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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 PENDING WV Primary

Addresses

Primary practice location

2900 1St Ave RM 1025
Huntington, WV 25702-1241

Mailing address

PO Box 417
White Sulphur Springs, WV 24986-0417
Phone (304) 536-5030

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rivas4@live.marshall.edu Direct St Mary's Hospitalist Services, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922003033 WV Practitioner - Internal Medicine 4789936857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Hospitalist Services LLCGroup PAC ID 2062552763, 45 clinicians

Practice addresses (Care Compare)

2900 1St Ave
RM 1025
Huntington, WV 25702-1241
Phone (304) 399-7484

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3747WVMDDentist
PENDINGWVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospitalist Services, LLC Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

2900 1st Ave
Rm 1025
Huntington, WV 25702
Phone (304) 399-7484

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

2900 1st Ave
#2E
Huntington, WV 25702
Phone (304) 399-2600

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1174012611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249860417",
            "telephone_number": "304-536-5030",
            "fax_number": "866-903-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE RM 1025",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-399-7484",
            "fax_number": "304-399-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "KENT",
        "middle_name": "ALAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rivas4@live.marshall.edu",
            "affiliation": "Y",
            "affiliationName": "St Mary's Hospitalist Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 1st Ave Rm 1025",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257021241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.