Organization Active NPI

Rio Vista Surgical Associates, P.C.

  • Surgery Physician
  • Lake Havasu City, AZ
National Provider Identifier
1699765834
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
24387 Issued in AZ
Legal business name
RIO VISTA SURGICAL ASSOCIATES, P.C.
Practice address
90 Riviera Dr
Lake Havasu City, AZ 86403-5716
Phone
(928) 453-2900
Fax
(877) 864-6566
NPI assigned
Oct 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Abedon Abe Saiz Jr., MDNPI 1477542934
Title
MD/Owner
Phone
(928) 453-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 24387 AZ Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X 24387 AZ

Addresses

Primary practice location

90 Riviera Dr
Lake Havasu City, AZ 86403-5716

Mailing address

90 Riviera Dr
Lake Havasu City, AZ 86403-5716
Phone (928) 453-2900

Other identifiers 1

IdentifierTypeStateIssuer
423878MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000978 AZ Part B Supplier - Clinic/Group Practice 0143215517 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Havasu City, AZ; Parker, AZ

National Provider Directory

National Provider Directory
Tax ID family
Rio Vista Surgical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1699765834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 RIVIERA DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035716",
            "telephone_number": "928-453-2900",
            "fax_number": "877-864-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 RIVIERA DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035716",
            "telephone_number": "928-453-2900",
            "fax_number": "877-864-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO VISTA SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "SAIZ",
        "authorized_official_first_name": "ABEDON",
        "authorized_official_middle_name": "ABE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "928-453-2900",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "AZ",
            "license": "24387",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "24387",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423878",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.