Individual provider Active NPI

Agustin Rivas, M.D.

  • General Practice Physician
  • Miami Springs, FL
National Provider Identifier
1205948783
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME100281 Issued in FL
Practice address
255 Westward Dr
Miami Springs, FL 33166-5259
Phone
(786) 621-9777
Fax
(786) 621-9601
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME100281 FL Primary
Pediatrics Physician 208000000X ME 100281 FL
Specialist 174400000X ME100281 FL

Addresses

Primary practice location

255 Westward Dr
Miami Springs, FL 33166-5259

Mailing address

255 Westward Dr
Miami Springs, FL 33166-5259
Phone (786) 621-9777

Other identifiers 2

IdentifierTypeStateIssuer
013332701MedicaidFL
013840000MedicaidFL

Other names 1

  • Agustin Rivas Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150714000962 FL Practitioner - Pediatric MedicinePractitioner - Family Practice 5698739019 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME100281FLMDSpecialist
ME 100281FLMDPediatrics Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1205948783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WESTWARD DR",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331665259",
            "telephone_number": "786-621-9777",
            "fax_number": "786-621-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WESTWARD DR",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331665259",
            "telephone_number": "786-621-9777",
            "fax_number": "786-621-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "AGUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME100281",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 100281",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME100281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013332701",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013840000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGUSTIN",
            "last_name": "RIVAS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami Springs, FL

Sources for this page

Verify at the official NPI Registry.