Jose Alfredo Rivera Sepulveda, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

94290 Issued in GA

Practice address

405 S College St
Statesboro, GA 30458-5409

Phone

(478) 621-2072

NPI assigned

Apr 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

50.51 of 100Reported as group

Quality

16.39

Improvement activities

20

Cost

79.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Gray, GA
  • NPI 1336492511
  Medicare reassignment NPD
• Optimus Diagnostics LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Macon, GA
  • NPI 1144609876
  NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1225590821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3594",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006813594",
            "telephone_number": "939-940-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S COLLEGE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585409",
            "telephone_number": "478-621-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA SEPULVEDA",
        "first_name": "JOSE",
        "middle_name": "ALFREDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "35269-R",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "94290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mollie Riggins
• Amy Jo Riggs, RD, LD
• James Lester Riggs, R. PH
• Susan B Riley, NP
• Thaddeus H Riley, M.D.
• Jennifer L Roberson, PTA
• Charlotte Elizabeth Roberts, LPC, MED, NCC, FCT 1
• Tonja Dawn Roberts, LPC
• Ann Robertson, NP
• Robin Sharp, MD

• Internal Medicine Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.