Individual provider Active NPI

Omar M Rivera, D.C.

  • Chiropractor
  • Sanford, FL
National Provider Identifier
1679693253
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9302 Issued in FL
Practice address
900 W 25TH St
Sanford, FL 32771-4236
Phone
(407) 878-5848
Fax
(407) 878-5850
NPI assigned
Mar 29, 2007
Last updated
Feb 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9302 FL Primary

Addresses

Primary practice location

900 W 25TH St
Sanford, FL 32771-4236

Mailing address

900 W 25TH St
Sanford, FL 32771-4236
Phone (407) 878-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080102000610 FL Practitioner - Chiropractic 5799865853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rivera Family Chiropractic Center LLCGroup PAC ID 6103088570, 2 clinicians

Practice addresses (Care Compare)

821 Debary Ave
Deltona, FL 32725-8805
Phone (386) 860-5448

900 W 25TH St
Sanford, FL 32771-4236
Phone (407) 878-5848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rivera Family Chiropractic Center Deltona LLC Chiropractor Current Accepting new patients
Rivera Family Chiropractic Center LLC CurrentSince Mar 14, 2012 Accepting new patients
Rivera Family Chiropractic Center Casselberry LLC Chiropractor Current Accepting new patients
Mauricio Chiropractic East Colonial, LLC Chiropractor Past Accepting new patients
Mauricio Chiropractic North LLC Chiropractor Past Accepting new patients

Locations

821 Debary Ave
Deltona, FL 32725
Phone (386) 860-5448

900 W 25th St
Sanford, FL 32771
Phone (407) 322-4155

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1679693253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W 25TH ST",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327714236",
            "telephone_number": "407-878-5848",
            "fax_number": "407-878-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 25TH ST",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327714236",
            "telephone_number": "407-878-5848",
            "fax_number": "407-878-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "OMAR",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.