Individual provider Active NPI

Adam Rivadeneyra, MD

  • Sports Medicine (Family Medicine) Physician
  • Orange, CA
National Provider Identifier
1689935355
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
A132857 Issued in CA
Practice address
280 S Main St Ste 200
Orange, CA 92868-3852
Phone
(714) 634-4567
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X A132857 CA
Family Medicine Physician 207Q00000X A132857 CA
Sports Medicine (Family Medicine) Physician 207QS0010X A132857 CA Primary

Addresses

Primary practice location

280 S Main St Ste 200
Orange, CA 92868-3852

Mailing address

280 S Main St Ste 200
Orange, CA 92868-3852
Phone (714) 634-4567

Other practice location 1

258 E Harvard Blvd
Santa Paula, CA 93060-3372
Phone (805) 525-5518

Other practice location 2

120 N Ashwood Ave
Ventura, CA 93003-1810
Phone (805) 652-5800

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
I20160616000647 CA Practitioner - Family PracticePractitioner - Sports Medicine 4284925579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

363 S Main St
Suite 220
Orange, CA 92868-3816
Phone (714) 634-4567

Hospital & facility affiliations

  • Hollywood Home Health Services Home health agency, N Hollywood, CA, CCN 058310
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
75.34 of 100Reported as group
Quality
48.62
Promoting interoperability
94
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132857CAMDMarriage & Family Therapist
A132857CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialty Institute Medical Group of Orange County CurrentSince Sep 1, 2017 Accepting new patients
Community Memorial Hospital District Past Accepting new patients
Community Memorial Health System Past Accepting new patients

Locations

16300 Sand Canyon Ave
Ste 511
Irvine, CA 92618
Phone (949) 255-9890

363 S Main St
Ste 220
Orange, CA 92868
Phone (714) 937-2193

280 S Main St
Ste 200
Orange, CA 92868
Phone (714) 937-2155

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: arivadeneyra@direct.osiortho.nextgenshare.com

Organizations & group practices 3

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 6

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689935355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST STE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683852",
            "telephone_number": "714-634-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST STE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683852",
            "telephone_number": "714-634-4567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 E Harvard Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Paula",
            "state": "CA",
            "postal_code": "930603372",
            "country_code": "US",
            "telephone_number": "805-525-5518",
            "fax_number": "805-525-9452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 N Ashwood Ave",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031810",
            "country_code": "US",
            "telephone_number": "805-652-5800",
            "fax_number": "805-642-1928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVADENEYRA",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A132857",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A132857",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A132857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.