Organization Active NPI

Lucian J Rivela MD PA

  • Plastic Surgery Physician
  • The Woodlands, TX
National Provider Identifier
1881766467
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
K4991 Issued in TX
Legal business name
LUCIAN J RIVELA MD PA
Practice address
9191 Pinecroft Dr
Suite 150
The Woodlands, TX 77380
Phone
(281) 681-3905
Fax
(281) 362-0403
NPI assigned
Nov 15, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Lucian Joseph Rivela, MDNPI 1407849565
Title
Owner
Phone
(281) 681-3905

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
Plastic Surgery Physician 208200000X K4991 TX Primary

Addresses

Primary practice location

9191 Pinecroft Dr
Suite 150
The Woodlands, TX 77380

Mailing address

1442 Kingwood Drive
PMB 73
Kingwood, TX 77339
Phone (281) 354-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100823001013 TX Part B Supplier - Clinic/Group Practice 2769506054 Receives reassigned benefits from 1 practitioner
Practice locations: Shenandoah, TX

National Provider Directory

National Provider Directory

Locations

9191 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 681-3905

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1881766467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 KINGWOOD DRIVE",
            "address_2": "PMB 73",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-354-1234",
            "fax_number": "281-354-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 PINECROFT DR",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "281-681-3905",
            "fax_number": "281-362-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCIAN J RIVELA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "RIVELA",
        "authorized_official_first_name": "LUCIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-681-3905",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "K4991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.