Individual provider Active NPI

Joel Antonio Martinez Rivera, DC

  • Chiropractor
  • Kissimmee, FL
National Provider Identifier
1205348216
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12283 Issued in FL
Practice address
1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621
Phone
(407) 801-0101
Fax
(407) 807-0008
NPI assigned
Oct 31, 2017
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12283 FL Primary

Addresses

Primary practice location

1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621

Mailing address

1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621
Phone (386) 801-4184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904001675 FL Practitioner - Chiropractic 3678013786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12283FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Isava Enterprise Inc Chiropractor CurrentSince Jun 14, 2024 Accepting new patients

Locations

1210 E Osceola Pkwy
Ste 302
Kissimmee, FL 34744
Phone (386) 801-4184

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1205348216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "386-801-4184",
            "fax_number": "407-807-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "407-801-0101",
            "fax_number": "407-807-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ RIVERA",
        "first_name": "JOEL",
        "middle_name": "ANTONIO",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-31",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.