Mario Carlos Rivera Bernuy, M.D

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

16030 Issued in ND

Practice address

1702 University Dr S
Fargo, ND 58103-4940

Phone

(701) 364-3300

NPI assigned

Jun 9, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mario Carlos Rivera Other name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 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

Specialty

Endocrinology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Hospital, Fargo, ND, CCN 350070
• Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
• Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• Innovis Health LLC

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504
  Medicare reassignment NPD
• Innovis Health LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD
• Innovis Health LLC

  • Family Medicine Physician
  • Fargo, ND
  • NPI 1578907655
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation
• Lake Region Healthcare Corporation

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  Care Compare affiliation
• Lake Region Healthcare Corporation

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Care Compare affiliation
• St Mary'S Regional Health Center

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482

  Hospital

  Care Compare affiliation
• St Marys Regional Health Center

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1730706656

  Hospital

  Care Compare affiliation
• St. Marys Regional Health Center

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Care Compare affiliation

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1841670445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University of New Mexico",
            "address_2": "MSC11 6093",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87131",
            "country_code": "US",
            "telephone_number": "505-272-6225",
            "fax_number": "505-272-5184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA BERNUY",
        "first_name": "MARIO",
        "middle_name": "CARLOS",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "69956",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2015-0333",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ND",
            "license": "16030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIO",
            "last_name": "RIVERA",
            "middle_name": "CARLOS",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Breana Ritchie
• Hannah M. Ritteman, LCSW
• Jonell J Rittmiller, R.N.
• Grace Elizabeth Ritz, RN
• Rachel Rebecca Rivard, OTR/L
• Riverview Family Dental PC
• RLN PLLC
• Alexis Jocelyn Roach, MS, CCC-SLP
• Katie Roach, LPCC
• Tanner Mark Robberstad, APRN, CRNA

• Endocrinology, Diabetes & Metabolism Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Endocrinology, Diabetes & Metabolism Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.