Individual provider Active NPI

Angel Luis Rivera Jr., M.D.

  • Psychiatry Physician
  • Visalia, CA
National Provider Identifier
1578610028
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
192860-1 Issued in NY
Practice address
520 E Tulare Ave
Visalia, CA 93292-3629
Phone
(559) 623-0900
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 192860-1 NY Primary

Addresses

Primary practice location

520 E Tulare Ave
Visalia, CA 93292-3629

Mailing address

1166 City Park LN
Decatur, GA 30033-6500
Phone (858) 798-6651

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000362 CA Practitioner - Psychiatry 0941497705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of TulareGroup PAC ID 1456264555, 32 clinicians

Practice addresses (Care Compare)

520 E Tulare Ave
Visalia, CA 93292-3629
Phone (559) 623-0900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
192860-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Tulare CurrentSince Mar 11, 2021 Accepting new patients
County of Tulare Current Accepting new patients
County of Tulare Current Accepting new patients
County of Tulare CurrentSince Mar 11, 2021 Accepting new patients

Locations

1055 W Henderson Ave
Porterville, CA 93257
Phone (559) 788-1200

520 E Tulare Ave
Visalia, CA 93292

5957 S Mooney Blvd
Visalia, CA 93277
Phone (559) 624-8000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1578610028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 CITY PARK LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336500",
            "telephone_number": "858-798-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923629",
            "telephone_number": "559-623-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "192860-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.