Individual provider Active NPI

Luis Carlo Rivera Martinez, MD

  • Pediatrics Physician
  • Omaha, NE
National Provider Identifier
1477133650
Registry record updated Sep 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10410 Issued in NE
Practice address
982161 Nebraska Medical Ctr
Omaha, NE 68198-2161
Phone
(402) 955-5700
NPI assigned
Apr 12, 2021
Last updated
Sep 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 10410 NE Primary

Addresses

Primary practice location

982161 Nebraska Medical Ctr
Omaha, NE 68198-2161

Mailing address

982161 Nebraska Medical Ctr
Omaha, NE 68198-2161
Phone (402) 955-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20251022000961 NE Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 6103314109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10410NEMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759017600000",
    "number": "1477133650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982161 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982161",
            "telephone_number": "402-955-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982161 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982161",
            "telephone_number": "402-955-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA MARTINEZ",
        "first_name": "LUIS",
        "middle_name": "CARLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-09-28",
        "certification_date": "2025-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "10410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.