Individual provider Active NPI

Ricardo Rivas, PA-C

  • Medical Physician Assistant
  • Temecula, CA
National Provider Identifier
1437581774
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14004 Issued in CA
Practice address
27699 Jefferson Ave Ste 312
Temecula, CA 92590-2697
Phone
(951) 676-4221
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14004 CA Primary

Addresses

Primary practice location

27699 Jefferson Ave Ste 312
Temecula, CA 92590-2697

Mailing address

27699 Jefferson Ave
Ste 312
Temecula, CA 92590-2697
Phone (951) 676-4221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131002842 CA Order and Referring Only - Physician Assistant 9234411018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA14004CAMDMedical Physician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBGECA/Endpoint/HBGECA

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1437581774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE",
            "address_2": "STE 312",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902697",
            "telephone_number": "951-676-4221",
            "fax_number": "951-676-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE STE 312",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902697",
            "telephone_number": "951-676-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "RICARDO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.