Manuel A. Rivera, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

26699 Issued in WI

Practice address

4536 22ND Ave
Kenosha, WI 53140-5917

Phone

(262) 656-0044

Fax

(262) 653-2218

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Emergency Medicine

Education

University of Texas Southwestern Medical School at Dallas, 1983

Medicare assignment

May accept Medicare assignment

Group practices

Kenosha Community Health Center, Inc.Group PAC ID 0941195168, shared by 5 NPIs, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrivera594912@direct.ochin.org
• Direct secure messaging: mrivera294378@direct.emplifyhealth.org

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.

• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kenosha, WI
  • NPI 1265435960
  Medicare reassignment NPD
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533

  Internal Medicine

  Medicare reassignment NPD
• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Racine, WI
  • NPI 1215823406
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Clinic Pharmacy
  • Friendship, WI
  • NPI 1669056693
  NPD
• LHH Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1902855653
  NPD (past)
• Palm Valley Emergency Physicians Specialists PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Brownsville, TX
  • NPI 1265408561
  NPD (past)
• PHS Indian Hospital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1508809765
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1184690133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044",
            "fax_number": "262-653-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405917",
            "telephone_number": "262-656-0044",
            "fax_number": "262-653-2218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Two Rivers",
            "state": "WI",
            "postal_code": "542413900",
            "country_code": "US",
            "telephone_number": "920-794-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "H0762",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "26699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Rios-Olivares, MSW
• Timothy Alan Risler, P.T., L.A.T
• Lisa Sue Ristau, RDH
• Amelia Ann Riutta
• Anna Lourdes Panlican Rivera, DMD
• Samreena Rizeq, DNP
• Vincent M Rizzo, MD
• Mitchell Robak, PHARMD
• Anne Robbins, C.T.P.
• Meredith Robbins, LPC, SAC

• Internal Medicine Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.