Individual provider Active NPI

Marvin Rivera

  • Physician Assistant
  • Arlington, TX
National Provider Identifier
1689381824
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19534 Issued in TX
Practice address
902 W Randol Mill Rd Ste 120
Arlington, TX 76012-2579
Phone
(817) 801-1503
Fax
(817) 801-1508
NPI assigned
Oct 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PA2761 NV
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA19534 TX Primary

Addresses

Primary practice location

902 W Randol Mill Rd Ste 120
Arlington, TX 76012-2579

Mailing address

951 Las Palmas Entrada Ave Apt 2126
Henderson, NV 89012-5631
Phone (469) 288-0058

Other practice location 1

2850 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-4395
Phone (702) 313-8446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230228002872 NV Practitioner - Physician Assistant 5092188722 Reassigns benefits to 1 organization
I20251031004034 TX Practitioner - Physician Assistant 5092188722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Springs Medical Group-Atkinson PCGroup PAC ID 5193988863, 6 clinicians
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

2850 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89052-4395
Phone (702) 313-8446

3802 Meadows LN
Las Vegas, NV 89107-3112
Phone (702) 313-8446

902 W Randol Mill Rd
Suite 120
Arlington, TX 76012-2579
Phone (817) 801-1503

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19534TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Nov 1, 2025 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Nov 1, 2025 Accepting new patients

Locations

902 W Randol Mill Rd
Ste 120
Arlington, TX 76012
Phone (817) 801-1503

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

Interoperability endpoints

  • Direct secure messaging: mrivera257859@direct.texashealth.org

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.

Hospital & facility affiliations 1

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": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1689381824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 LAS PALMAS ENTRADA AVE APT 2126",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125631",
            "telephone_number": "469-288-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W RANDOL MILL RD STE 120",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122579",
            "telephone_number": "817-801-1503",
            "fax_number": "817-801-1508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-313-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "PA2761",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.