Individual provider Active NPI

Debra Covarrubias Rivas, N.P.

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1902819261
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16082 Issued in CA
Practice address
751 S Bascom Ave
Pulmonary Department
San Jose, CA 95128-2604
Phone
(408) 885-3926
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 570338 CA
Nurse Practitioner 363L00000X 16082 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
Pulmonary Department
San Jose, CA 95128-2604

Mailing address

PO Box 742502
Los Angeles, CA 90074-2502
Phone (408) 885-5000

Other identifiers 1

IdentifierTypeStateIssuer
C3032212OtherCADRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015001870 CA Practitioner - Nurse Practitioner 9436370418 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16082CAMDProfessional Counselor
570338CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Aug 12, 2014 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Aug 12, 2014 Accepting new patients
County of Santa Clara CurrentSince Aug 12, 2014 Accepting new patients
County of Santa Clara Current Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

751 S Bascom Ave
Fl 5
San Jose, CA 95128

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1902819261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742502",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742502",
            "telephone_number": "408-885-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "PULMONARY DEPARTMENT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "DEBRA",
        "middle_name": "COVARRUBIAS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "570338",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "16082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "C3032212",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.