Organization Active NPI

Homero Rivero MD PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1821153776
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOMERO RIVERO MD PA
Practice address
6741 Coral Way
Ste 50 51
Miami, FL 33155-1762
Phone
(305) 264-9767
Fax
(305) 264-9768
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Authorized official

Name
Homero Rivero, MDNPI 1275573495
Title
Owner
Phone
(305) 264-9767

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6741 Coral Way
Ste 50 51
Miami, FL 33155-1762

Mailing address

6741 Coral Way
Ste 50 51
Miami, FL 33155-1762
Phone (305) 264-9767

Other identifiers 2

IdentifierTypeStateIssuer
30583OtherFLBCBS
272128700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051114000551 FL Part B Supplier - Clinic/Group Practice 7113946765 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

6741 SW 24th St
Ste 50
Miami, FL 33155
Phone (305) 264-9767

Practitioners & affiliated clinicians

Practitioners 2

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": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1821153776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 CORAL WAY",
            "address_2": "STE 50 51",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551762",
            "telephone_number": "305-264-9767",
            "fax_number": "305-264-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 CORAL WAY",
            "address_2": "STE 50 51",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551762",
            "telephone_number": "305-264-9767",
            "fax_number": "305-264-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMERO RIVERO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "RIVERO",
        "authorized_official_first_name": "HOMERO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-264-9767",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30583",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272128700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.