Ismael Hiram Soto Rivas, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301113708 Issued in MI

Practice address

2725 Airview Blvd Ste 105
Portage, MI 49002

Phone

(269) 349-8386

Fax

(269) 349-8397

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1699787556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 AIRVIEW BLVD STE 105",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021804",
            "telephone_number": "269-349-8386",
            "fax_number": "269-349-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 AIRVIEW BLVD STE 105",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-349-8386",
            "fax_number": "269-349-8397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Armstrong Road",
            "address_2": "Battle Creek VA Medical Center",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "49037",
            "country_code": "US",
            "telephone_number": "269-966-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5500 Armstrong Road",
            "address_2": "Battle Creek VA Medical Center",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "49037",
            "country_code": "US",
            "telephone_number": "269-966-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO RIVAS",
        "first_name": "ISMAEL",
        "middle_name": "HIRAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "13373",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301113708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE-S",
            "identifier": "21479 SO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Portage, MI
• Providers in Portage, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.