Individual provider Active NPI

Alison Saulog Rivera, MD

  • Pediatrics Physician
  • Sugar Land, TX
National Provider Identifier
1366709586
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-19593 Issued in HI
Practice address
15551 Southwest Fwy
Sugar Land, TX 77478-3830
Phone
(281) 325-1010
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD.207464 LA
Pediatrics Physician 208000000X Q4835 TX
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD-19593 HI Primary

Addresses

Primary practice location

15551 Southwest Fwy
Sugar Land, TX 77478-3830

Mailing address

406 Detering St
Houston, TX 77007-7127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20180501002648 HI Practitioner - Pediatric Medicine 6901160852 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-19593HIMDPediatrics Physician
MD.207464LAMDPediatrics Physician
Q4835TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinic of Maui Inc CurrentSince Apr 9, 2018 Accepting new patients
Community Clinic of Maui, Inc. CurrentSince Apr 9, 2018 Accepting new patients
Community Clinic of Maui, Inc. Current Accepting new patients
Community Clinic of Maui, Inc. PastSince Apr 14, 2024 Accepting new patients

Locations

250 E Lipoa St
Kihei, HI 96753
Phone (808) 871-7772

1881 Nani St
Wailuku, HI 96793
Phone (808) 871-7772

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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1366709586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 DETERING ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770077127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15551 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783830",
            "telephone_number": "281-325-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ALISON",
        "middle_name": "SAULOG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.207464",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q4835",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-19593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.