Individual provider Active NPI

Marcelo R Rivera, M.D.

  • Specialist
  • Poway, CA
National Provider Identifier
1942311311
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G39240 Issued in CA
Practice address
15644 Pomerado Rd
#300
Poway, CA 92064-2400
Phone
(858) 613-8743
Fax
(858) 613-9274
NPI assigned
Aug 31, 2006
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G39240 CA Primary

Addresses

Primary practice location

15644 Pomerado Rd
#300
Poway, CA 92064-2400

Mailing address

15644 Pomerado Rd
#300
Poway, CA 92064-2400
Phone (858) 613-8743

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000586 CA Practitioner - Internal Medicine 3173692316 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15644 Pomerado Rd
Suite 100
Poway, CA 92064-2419

15644 Pomerado Rd
Suite 300
Poway, CA 92064-2418
Phone (858) 613-8743

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince May 1, 2013 Accepting new patients
Ficaremed PC CurrentSince Aug 5, 2024 Accepting new patients
Ficaremed Psychological Services Inc CurrentSince Oct 13, 2024 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Marcelo R. Rivera, MD, Inc. Specialist CurrentSince Jan 1, 1999 Accepting new patients
Galen Inpatient Physicians Inc Internal Medicine CurrentSince May 1, 2013 Accepting new patients
Primary Care Center of North County, Apc CurrentSince Jul 2, 2011 Accepting new patients
Palomar Health Past Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

13525 Midland Rd
Ste F
Poway, CA 92064
Phone (858) 335-4012

15644 Pomerado Rd
Ste 100
Poway, CA 92064
Phone (858) 485-5111

15644 Pomerado Rd
Ste 300
Poway, CA 92064
Phone (760) 739-7666

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1942311311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15644 POMERADO RD",
            "address_2": "#300",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642400",
            "telephone_number": "858-613-8743",
            "fax_number": "858-613-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15644 POMERADO RD",
            "address_2": "#300",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642400",
            "telephone_number": "858-613-8743",
            "fax_number": "858-613-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARCELO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G39240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.