Individual provider Active NPI

Rudy Rivera

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1205374162
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
150 E Sonterra Blvd
Suite 220
San Antonio, TX 78258-4098
Phone
(210) 481-6800
Fax
(210) 481-1444
NPI assigned
Feb 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

150 E Sonterra Blvd
Suite 220
San Antonio, TX 78258-4098

Mailing address

18818 Meisner Dr
Ste 102
San Antonio, TX 78258-3569
Phone (210) 481-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181031001866 TX Practitioner - Physician Assistant 5092068510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

18818 Meisner Dr
San Antonio, TX 78258-3568
Phone (210) 481-6800

3011 W Loop 1604
San Antionio, TX 78251-3901
Phone (210) 681-6176

3011 W Loop 1604 N Access Rd
San Antonio, TX 78251-3901
Phone (866) 309-2873

3903 Wiseman Blvd
San Antonio, TX 78251-4402
Phone (210) 946-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Oct 1, 2019 Accepting new patients
BHS Physicians Network, Inc CurrentSince Oct 1, 2019 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

18818 Meisner Dr
Ste 102
San Antonio, TX 78258
Phone (210) 481-6800

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: rudy.rivera.1@1438.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1205374162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18818 MEISNER DR",
            "address_2": "STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583569",
            "telephone_number": "210-481-6800",
            "fax_number": "210-481-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E SONTERRA BLVD",
            "address_2": "SUITE 220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584098",
            "telephone_number": "210-481-6800",
            "fax_number": "210-481-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RUDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-10",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.