Individual provider Active NPI

Cristian Ruperto Rivera Rodriguez, MD

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1356912968
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD486355 Issued in PA
Practice address
451 Chew St Ste 400
Allentown, PA 18102-3472
Phone
(484) 822-5970
Fax
(833) 691-7857
NPI assigned
Jul 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD486355 PA Primary

Addresses

Primary practice location

451 Chew St Ste 400
Allentown, PA 18102-3472

Mailing address

450 Chew St
Allentown, PA 18102-3434
Phone (610) 776-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240821000085 PA Practitioner - Family Practice 5799223897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

4311 Easton Ave
Bethlehem, PA 18020-1431
Phone (610) 954-3600

4379 Easton Ave
101 Family Prac Palmer
Bethlehem, PA 18020-1431
Phone (610) 814-2424

451 Chew St
Allentown, PA 18102-3472
Phone (484) 526-2400

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Jul 26, 2024 Accepting new patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Jul 26, 2024 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

451 Chew St
Ste 400
Allentown, PA 18102
Phone (610) 434-4445

450 Chew St
Allentown, PA 18102
Phone (610) 776-4802

451 Chew St
Ste 4002
Allentown, PA 18102

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: crivera261883@direct-sluhn.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1356912968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CHEW ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023434",
            "telephone_number": "610-776-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CHEW ST STE 400",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023472",
            "telephone_number": "484-822-5970",
            "fax_number": "833-691-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA RODRIGUEZ",
        "first_name": "CRISTIAN",
        "middle_name": "RUPERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD486355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.