Rostom Dano Rivera, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00010356 Issued in WA

Practice address

7808 Pacific Ave Ste 4
Tacoma, WA 98408-7039

Phone

(253) 474-3329

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Rostom D Rivera, MD

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1407012578
  NPD (past) Authorized official
• Women'S Holistic Medical Weight Loss Clinic LLC

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1467107508
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1366511552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 PACIFIC AVE STE 4",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087039",
            "telephone_number": "253-474-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 PACIFIC AVE STE 4",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087039",
            "telephone_number": "253-474-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ROSTOM",
        "middle_name": "DANO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00010356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "12776",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "RI2850",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031608",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "AETNA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Efrain Rivera, M.D.
• Guadalupe Rivera
• Jean L Rivera, LICSW, CADCI
• Melvin Rivera, RN00132317
• Naida Rivera
• Carmelita Rivero, RN
• Aerith May Rivers
• Emily Rivers
• Jessica Koryn Rivers
• Kaiten A Rivers, ND

• Family Medicine Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.