Active NPI
Carlos Marcial Rivero-Pena
- Homemaker
- Las Vegas, NV
National Provider Identifier
1922640788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 4550 W Oakey Blvd Ste 111-O
Las Vegas, NV 89102-1581 - Phone
- (702) 861-0238
- NPI assigned
- Oct 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
4550 W Oakey Blvd Ste 111-O
Las Vegas, NV 89102-1581
Mailing address
4763 E Harmon Ave
Las Vegas, NV 89121-6921
Phone (702) 906-9213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821520016 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1922640788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4763 E HARMON AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891216921",
"telephone_number": "702-906-9213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 W OAKEY BLVD STE 111-O",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891021581",
"telephone_number": "702-861-0238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERO-PENA",
"first_name": "CARLOS",
"middle_name": "MARCIAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-14",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821520016",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.