Individual provider Active NPI

Estevan Rivas

  • Family Medicine Physician
  • Indio, CA
National Provider Identifier
1477916260
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO034859 Issued in DC
Practice address
47923 Oasis St
Indio, CA 92201-9203
Phone
(760) 863-8283
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A22780 CA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO034859 DC Primary

Addresses

Primary practice location

47923 Oasis St
Indio, CA 92201-9203

Mailing address

15611 Newkirk Rd
El Paso, TX 79928-9046
Phone (915) 252-6173

Other practice location 1

1660 Columbia Rd NW
Washington, DC 20009-3602
Phone (202) 469-4699 ext. 5123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20191010001335 DC Practitioner - Family Practice 5193012730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, shared by 16 NPIs, 190 clinicians

Practice addresses (Care Compare)

191 N Sunrise Way
Palm Springs, CA 92262-5201
Phone (760) 778-2210

Hospital & facility affiliations

  • Guardian Angel Home Care, Inc Home health agency, Palm Desert, CA, CCN 059645
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22780CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care Inc. CurrentSince Aug 18, 2019 Accepting new patients
Unity Health Care, Inc. CurrentSince Aug 18, 2019 Accepting new patients

Locations

1100 New Jersey Ave SE
Ste 500
Washington, DC 20003
Phone (202) 279-1817

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

1660 Columbia Rd NW
Washington, DC 20009
Phone (202) 328-3717

Interoperability endpoints

  • Direct secure messaging: erivas1223528@direct.llu.edu

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.

Hospital & facility affiliations 2

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1477916260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 NEWKIRK RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799289046",
            "telephone_number": "915-252-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47923 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922019203",
            "telephone_number": "760-863-8283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 Columbia Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200093602",
            "country_code": "US",
            "telephone_number": "202-469-4699 x5123",
            "fax_number": "202-548-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "ESTEVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22780",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "DO034859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.