NPIMap

Individual provider Active NPI

Richard Rivera, MD

  • Family Medicine Physician
  • Pueblo, CO
National Provider Identifier
1710952577
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19885 Issued in CO
Practice address
1080 Chinook LN
Pueblo, CO 81001-1850
Phone
(719) 564-9400
Fax
(719) 564-0497
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19885 CO Primary

Addresses

Primary practice location

1080 Chinook LN
Pueblo, CO 81001-1850

Mailing address

1080 Chinook LN
Pueblo, CO 81001-1850
Phone (719) 564-9400

Other identifiers 1

IdentifierTypeStateIssuer
01198852MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000546 CO Practitioner - Family Practice 5890706832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Harvard Medical School, 1974
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1080 Chinook LN
Pueblo, CO 81001-1850
Phone (719) 564-9400

127 Justice Ctr Rd J
Canon City, CO 81212-9378
Phone (719) 269-1136

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions20
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19885COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Rivera MDPC CurrentSince Jan 1, 1976 Accepting new patients
Richard Rivera MDPC Past Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients

Locations

127 Justice Center Rd
Ste J
Canon City, CO 81212
Phone (719) 269-1136

1080 Chinook Ln
Pueblo, CO 81001
Phone (719) 564-9400

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 10

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1710952577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011850",
            "telephone_number": "719-564-9400",
            "fax_number": "719-564-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011850",
            "telephone_number": "719-564-9400",
            "fax_number": "719-564-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "19885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01198852",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.