Individual provider Active NPI

Kevin John Reyes Rivera, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1760986715
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A193862 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Mar 22, 2018
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A193862 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD-49621 IA
Child & Adolescent Psychiatry Physician 2084P0804X 322373 NY

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
San Diego, CA 92103-9000

Other practice location 1

350 Dickinson St
San Diego, CA 92103-1913
Phone (800) 926-8273

Other practice location 2

680 Fletcher Pkwy Ste 200
El Cajon, CA 92020-2500
Phone (619) 515-2365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230517001745 NY Practitioner - Psychiatry 9032465653 Reassigns benefits to 1 organization
I20240727000691 CA Practitioner - Psychiatry 9032465653 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

490 N Grape St
Escondido, CA 92025-3079
Phone (760) 975-9939

6645 Alvarado Rd
San Diego, CA 92120-5208
Phone (858) 249-6748

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-5273

8950 Villa la Jolla Dr
La Jolla, CA 92037-1714
Phone (858) 249-6748

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193862CAMDPsychiatry Physician
MD-49621IAMDChild & Adolescent Psychiatry Physician
322373NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Aug 26, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Oct 11, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 26, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Nys Office of Mental Health CurrentSince Jul 1, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Oct 11, 2024 Accepting new patients
Regents of the University of California Psychiatry CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2024 Accepting new patients
Nys Office of Mental Health Current Accepting new patients
Nys Office of Mental Health CurrentSince Jul 1, 2023 Accepting new patients
Community Research Foundation Inc CurrentSince Aug 1, 2024 Accepting new patients
Family Health Centers of San Diego, Inc PastSince Nov 24, 2019 Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

678 Third Ave
Chula Vista, CA 91910

490 N Grape St
Escondido, CA 92025
Phone (760) 975-9939

8950 Villa La Jolla Dr
Ste C101
La Jolla, CA 92037
Phone (858) 249-1680

8950 Villa La Jolla Dr
Ste C106
La Jolla, CA 92037

File 57326
Los Angeles, CA 90074

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

350 Dickinson St
San Diego, CA 92103
Phone (619) 543-6635

4250 1st Ave
San Diego, CA 92103
Phone (619) 471-0238

4510 Executive Dr
Ste 315
San Diego, CA 92121
Phone (858) 534-8019

6645 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3172

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1051 Riverside Dr
New York, NY 10032
Phone (212) 543-5000

998 Crooked Hill Rd
West Brentwood, NY 11717
Phone (631) 306-5732

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1760986715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Dickinson St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921031913",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Fletcher Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920202500",
            "country_code": "US",
            "telephone_number": "619-515-2365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KEVIN JOHN",
        "middle_name": "REYES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A193862",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IA",
            "license": "MD-49621",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "322373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.