Active NPI
Martin E Rivera, CRNA
- Certified Registered Nurse Anesthetist
- Jacksonville, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1139215
- Practice address
- 2626 S Jackson
Jacksonville, TX 75766 - Phone
- (903) 541-4630
- Fax
- (903) 586-5710
- NPI assigned
- Jan 26, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 073074 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 1139215 | TX | Primary |
Addresses
Primary practice location
2626 S Jackson
Jacksonville, TX 75766
Mailing address
PO Box 220
Rolla, MO 65402-0220
Phone (573) 458-8899
Other practice location 1
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 917426801 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 N Winnsboro St
Ut Health Quitman
Quitman, TX 75783-2144
Phone (903) 763-6300
11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7000
2000 S Palestine St
Athens, TX 75751-5610
Phone (903) 675-2216
224 E 2ND St
Moore County Hosp Dist
Dumas, TX 79029-3808
Phone (806) 934-7824
7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 073074 | MO | MD | Certified Registered Nurse Anesthetist |
| 1139215 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mother Frances Hospital Jacksonville | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Emergenchealth PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006
3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002
6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818
6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302
7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Fort Worth, TX
- NPI 1467970897
Nurse Anesthetist, Certified Registered
-
- Critical Access Hospital
- Jacksonville, TX
- NPI 1952306672
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Athens, TX
- NPI 1417465824
-
- Critical Access Hospital
- Dumas, TX
- NPI 1700991700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742428800000",
"number": "1184694416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 220",
"city": "ROLLA",
"state": "MO",
"postal_code": "654020220",
"telephone_number": "573-458-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 S JACKSON",
"city": "JACKSONVILLE",
"state": "TX",
"postal_code": "75766",
"telephone_number": "903-541-4630",
"fax_number": "903-586-5710"
}
],
"practiceLocations": [
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-458-8899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIVERA",
"first_name": "MARTIN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2025-03-20",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "073074",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1139215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "917426801",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.