Active NPI
Gabriel Rivera-Rodriguez, MD
- Nephrology Physician
- Marrero, LA
National Provider Identifier
1366434151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 10953R
- Practice address
- 1111 Medical Center Blvd
Suite N511
Marrero, LA 70072-3151 - Phone
- (504) 349-6301
- Fax
- (504) 349-6308
- NPI assigned
- Aug 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 10953R | LA | Primary |
Addresses
Primary practice location
1111 Medical Center Blvd
Suite N511
Marrero, LA 70072-3151
Mailing address
4409 Utica St
Suite 100
Metairie, LA 70006-6530
Phone (504) 457-3687
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1946095 | Other | LA | GROUP MEDICAID # |
| 5F615 | Other | LA | GROUP MEDICARE # |
| 1437254984 | Other | LA | GROUP NPI - NEW ORLEANS NEPHROLOGY |
| 199318 | Medicaid | LA |
Other names 1
- Gabriel Rivera
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10953R | LA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1366434151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 UTICA ST",
"address_2": "SUITE 100",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700066530",
"telephone_number": "504-457-3687",
"fax_number": "504-620-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MEDICAL CENTER BLVD",
"address_2": "SUITE N511",
"city": "MARRERO",
"state": "LA",
"postal_code": "700723151",
"telephone_number": "504-349-6301",
"fax_number": "504-349-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA-RODRIGUEZ",
"first_name": "GABRIEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "LA",
"license": "10953R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID #",
"identifier": "1946095",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE #",
"identifier": "5F615",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI - NEW ORLEANS NEPHROLOGY",
"identifier": "1437254984",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199318",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GABRIEL",
"last_name": "RIVERA",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.