NPIMap

Individual provider Active NPI

Kristine M Rivera, DO

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1437186376
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40835 Issued in CO
Practice address
4020 Jerry Murphy Road
Pueblo, CO 81001
Phone
(719) 546-3600
Fax
(719) 546-0931
NPI assigned
Jun 27, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40835 CO Primary

Addresses

Primary practice location

4020 Jerry Murphy Road
Pueblo, CO 81001

Mailing address

4020 Jerry Murphy Road
Pueblo, CO 81001
Phone (719) 546-3600

Other identifiers 1

IdentifierTypeStateIssuer
17334349MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001183 CO Practitioner - Family Practice 2163403312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2001
Medicare assignment
May accept Medicare assignment
Group practices
The Family Clinic of Fort CollinsGroup PAC ID 5890684179, 8 clinicians

Practice addresses (Care Compare)

1212 E Elizabeth St
Fort Collins, CO 80524-4007
Phone (970) 482-2791

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions31
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40835COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Clinic of Fort Collins Family Medicine CurrentSince Jun 1, 2012 Accepting new patients
Julie Devita-Bailey, D.O., P.C. Family Medicine Past Accepting new patients
University Family Medicine Center, P.C. Family Medicine PastSince Dec 1, 1995 Accepting new patients
Hospitalists of Pueblo Past Accepting new patients

Locations

1212 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 482-2791

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1437186376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 JERRY MURPHY ROAD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81001",
            "telephone_number": "719-546-3600",
            "fax_number": "719-546-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 JERRY MURPHY ROAD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81001",
            "telephone_number": "719-546-3600",
            "fax_number": "719-546-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "40835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17334349",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.