Individual provider Active NPI

Andrew Laurence Rivard, MD

  • Diagnostic Radiology Physician
  • Jackson, MS
National Provider Identifier
1780645028
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
21193 Issued in MS
Practice address
2500 State Street
University of Mississippi Medical Center
Jackson, MS 39216
Phone
(601) 984-1000
NPI assigned
Mar 28, 2006
Last updated
Mar 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 45475 MN
Diagnostic Radiology Physician 2085R0202X 21193 MS Primary

Addresses

Primary practice location

2500 State Street
University of Mississippi Medical Center
Jackson, MS 39216

Mailing address

2500 North State Street
University of Mississippi Medical Center
Jackson, MS 39216
Phone (601) 984-2538

Other identifiers 1

IdentifierTypeStateIssuer
P01167582OtherMSRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IN2 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
I20101117001619 MS Practitioner - Diagnostic Radiology 9133026461 Reassigns benefits to 1 organization
I20250212002397 IN Practitioner - Diagnostic Radiology 9133026461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (219) 757-6320

253 Ridge Dr
Jackson, MS 39216-4112
Phone (888) 501-6087

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45475MNMDDiagnostic Radiology Physician
21193MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Nov 7, 2024 Accepting new patients
Sibley Medical Center Past Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

Organizations & group practices 4

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.

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1780645028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-2538",
            "fax_number": "601-815-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STATE STREET",
            "address_2": "UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "ANDREW",
        "middle_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "45475",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "21193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01167582",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.