Individual provider Active NPI

Jenna Rivera Haney, DO

  • Internal Medicine Physician
  • Tyler, TX
National Provider Identifier
1851021752
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V7900 Issued in TX
Practice address
520 Douglas Blvd
Tyler, TX 75702-8307
Phone
(903) 606-1721
Fax
(903) 525-1230
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X V7900 TX Primary

Addresses

Primary practice location

520 Douglas Blvd
Tyler, TX 75702-8307

Mailing address

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 606-1721

Other names 1

  • Jenna Marie Rivera Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250813001459 TX Practitioner - Internal Medicine 2062910516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

5321 S FM
14 Christus Trinity Clinic
Holly Lake Ranch, TX 75765-4839
Phone (903) 769-2990

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V7900TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Sep 8, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 8, 2025 Accepting new patients

Locations

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

701 E Marshall Ave
Ste 400
Longview, TX 75601
Phone (903) 315-1696

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: jrivera285698@christushealth.direct-ci.net

Organizations & group practices 2

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 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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1851021752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028307",
            "telephone_number": "903-606-1721",
            "fax_number": "903-525-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028307",
            "telephone_number": "903-606-1721",
            "fax_number": "903-525-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "JENNA",
        "middle_name": "RIVERA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V7900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "RIVERA",
            "middle_name": "MARIE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.