Individual provider Active NPI

Mariana Alejandra Rivera Rodriguez, MD

  • Internal Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1417482043
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME157842 Issued in FL
Practice address
20 Cypress Point Pkwy Ste a
Palm Coast, FL 32164-7528
Phone
(386) 586-7005
Fax
(844) 867-3940
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME157842 FL Primary

Addresses

Primary practice location

20 Cypress Point Pkwy Ste a
Palm Coast, FL 32164-7528

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mariana.rivera.rodriguez.1@29601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221126000073 FL Practitioner - Internal Medicine 6608112578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
San Juan Bautista School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

20 Cypress Point Pkwy
Suite 1
Palm Coast, FL 32164-7528
Phone (386) 586-7005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME157842FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Nov 7, 2022 Accepting new patients

Locations

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

5238-16 Norwood Ave
Jacksonville, FL 32208
Phone (904) 467-7512

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

20 Cypress Point Pkwy
Ste A
Palm Coast, FL 32164
Phone (386) 586-7005

20 Cypress Point Pkwy
#1
Palm Coast, FL 32164
Phone (386) 206-5177

7101 W McNab Rd
Ste 101
Tamarac, FL 33321
Phone (954) 722-5600

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.

Hospital & facility affiliations 1

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1417482043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CYPRESS POINT PKWY STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647528",
            "telephone_number": "386-586-7005",
            "fax_number": "844-867-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA RODRIGUEZ",
        "first_name": "MARIANA",
        "middle_name": "ALEJANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME157842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariana.rivera.rodriguez.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "20 Cypress Point Pkwy Ste A",
            "city": "Palm Coast",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321647528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.