Ismael Omar Rivera, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q1282 Issued in TX

Practice address

100 W Dean Keeton St Stop A3900
Austin, TX 78712-1107

Phone

(512) 804-3202

Fax

(512) 901-9717

NPI assigned

May 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD (past)
• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1801237748
  NPD (past)
• University Health Services

  • Health Service Clinic/Center
  • Austin, TX
  • NPI 1740313337
  NPD (past)

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1891087102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 S IH 35 STE 174",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "733012701",
            "telephone_number": "512-804-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W DEAN KEETON ST STOP A3900",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121107",
            "telephone_number": "512-804-3202",
            "fax_number": "512-901-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ISMAEL",
        "middle_name": "OMAR",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10039553",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Rivera, PT, DPT
• Emily Rivera, APRN, WHNP-BC
• Emmanuel Rivera
• Gabriela Rivera
• Genesis Rivera
• Marissa Rivera
• Marissa Kathleen Rivera
• Martha Laura Rivera, CCC-A
• Mary Rivera
• Paul R Rivera, DDS

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.