NPIMap

Individual provider Active NPI

Robert H Rivera, MD

  • Internal Medicine Physician
  • Burbank, CA
National Provider Identifier
1659447977
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A67652 Issued in CA
Practice address
333 E Magnolia Blvd Ste 103
Burbank, CA 91502-1198
Phone
(818) 848-1555
Fax
(818) 842-9323
NPI assigned
Nov 28, 2006
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A67652 CA Primary

Addresses

Primary practice location

333 E Magnolia Blvd Ste 103
Burbank, CA 91502-1198

Mailing address

333 E Magnolia Blvd
Ste 103
Burbank, CA 91502-1198
Phone (818) 848-1555

Other identifiers 4

IdentifierTypeStateIssuer
X55988OtherGROUP UPN #
00A67652MedicaidCA
GR0089090OtherGROUP MEDICAL
W1515OtherEDI

Other names 1

  • Robert H Rivera Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110427000661 CA Practitioner - Internal Medicine 4486692845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Advanced Health Medical Group IncGroup PAC ID 5698713055, 4 clinicians

Practice addresses (Care Compare)

333 E Magnolia Blvd
Suite 103
Burbank, CA 91502-1198
Phone (818) 848-1555

511 Western Ave
Glendale, CA 91201-2870
Phone (818) 240-5588

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67652CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Razmik Ohanjanian MD Inc CurrentSince May 31, 2010 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Vachik Shahnazarian MD Inc PastSince Sep 15, 2003 Accepting new patients

Locations

511 Western Ave
Glendale, CA 91201
Phone (818) 240-5588

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: robertriveramd@ah-ca.direct.office.nextgen.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1659447977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E MAGNOLIA BLVD",
            "address_2": "STE 103",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021198",
            "telephone_number": "818-848-1555",
            "fax_number": "818-842-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E MAGNOLIA BLVD STE 103",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021198",
            "telephone_number": "818-848-1555",
            "fax_number": "818-842-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ROBERT",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A67652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP UPN #",
            "identifier": "X55988",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A67652",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAL",
            "identifier": "GR0089090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDI",
            "identifier": "W1515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "RIVERA",
            "middle_name": "H",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.