Individual provider Active NPI

Luis Rafael Rivera Aguasvivas, MD

  • Colon & Rectal Surgery Physician
  • Montgomery, AL
National Provider Identifier
1972064103
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
49314 Issued in AL
Practice address
2055 E South Blvd Ste 601
Montgomery, AL 36116-2014
Phone
(334) 747-2999
NPI assigned
Mar 29, 2019
Reactivated
Nov 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN29803 FL
Colon & Rectal Surgery Physician 208C00000X 49314 AL Primary

Addresses

Primary practice location

2055 E South Blvd Ste 601
Montgomery, AL 36116-2014

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005

Other practice location 1

1611 NW 12 Avenue
Holtz Building, East Tower 2169
Miami, FL 33136
Phone (305) 585-1280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20250611002438 AL Practitioner - Colorectal Surgery (Proctology) 6608386313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2055 E S Blvd
Suite 601
Montgomery, AL 36116-2014
Phone (334) 747-2999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49314ALMDColon & Rectal Surgery Physician
TRN29803FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Aug 1, 2025 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Aug 1, 2025 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients

Locations

2055 E South Blvd
Ste 601
Montgomery, AL 36116
Phone (334) 281-9000

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

Organizations & group practices 4

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1972064103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 601",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162014",
            "telephone_number": "334-747-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12 Avenue",
            "address_2": "Holtz Building, East Tower 2169",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33136",
            "country_code": "US",
            "telephone_number": "305-585-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA AGUASVIVAS",
        "first_name": "LUIS",
        "middle_name": "RAFAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "deactivation_date": "2019-11-04",
        "reactivation_date": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN29803",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "AL",
            "license": "49314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.