Individual provider Active NPI

Jesus Rivera-Nieves, M.D.

  • Gastroenterology Physician
  • San Diego, CA
National Provider Identifier
1437228079
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C54808 Issued in CA
Practice address
200 West Arbor Drive
Mail Code 9111D
San Diego, CA 92103-9111
Phone
(858) 534-5495
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 45500 CO
Gastroenterology Physician 207RG0100X C54808 CA Primary

Addresses

Primary practice location

200 West Arbor Drive
Mail Code 9111D
San Diego, CA 92103-9111

Mailing address

9500 Gilman Dr
BLDG. Uc303 RM. 211 MC 0063
La Jolla, CA 92093-0063
Phone (858) 534-5495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C54808CAMDGastroenterology Physician
45500COMDGastroenterology Physician
54808CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Hospital Past Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Organizations & group practices 2

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1437228079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "BLDG. UC303 RM. 211 MC 0063",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930063",
            "telephone_number": "858-534-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST ARBOR DRIVE",
            "address_2": "MAIL CODE 9111D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039111",
            "telephone_number": "858-534-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-NIEVES",
        "first_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "45500",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C54808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.