Individual provider Active NPI

Lucian Joseph Rivela, MD

  • Plastic Surgery Physician
  • The Woodlands, TX
National Provider Identifier
1407849565
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
K4991 Issued in TX
Practice address
9191 Pinecroft Drive
Ste 150
The Woodlands, TX 77380
Phone
(281) 681-3905
Fax
(281) 362-0403
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X K4991 TX Primary

Addresses

Primary practice location

9191 Pinecroft Drive
Ste 150
The Woodlands, TX 77380

Mailing address

3007 Woodland Hills Drive
PMB 73
Kingwood, TX 77339
Phone (281) 354-1234

Other identifiers 1

IdentifierTypeStateIssuer
162775401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100823001032 TX Practitioner - Plastic and Reconstructive Surgery 3678697968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9191 Pinecroft Dr
Suite 150
Shenandoah, TX 77380-2799
Phone (281) 681-3905

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lucian J Rivela MD PA Plastic Surgery CurrentSince Feb 25, 2003 Accepting new patients

Locations

1442 Kingwood Dr
Kingwood, TX 77339

9191 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 681-3905

Organizations & group practices 1

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1407849565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 WOODLAND HILLS DRIVE",
            "address_2": "PMB 73",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-354-1234",
            "fax_number": "281-354-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 PINECROFT DRIVE",
            "address_2": "STE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-681-3905",
            "fax_number": "281-362-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVELA",
        "first_name": "LUCIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "K4991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162775401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.