Individual provider Active NPI

Michelle Y. Rivera-Vega, M.D.

  • Pediatric Endocrinology Physician
  • Orlando, FL
National Provider Identifier
1992992432
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME165149 Issued in FL
Practice address
60 W Gore St
Orlando, FL 32806-1141
Phone
(321) 843-1182
Fax
(321) 841-3305
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C167414 CA
Pediatric Endocrinology Physician 2080P0205X ME120252 FL
Pediatric Endocrinology Physician 2080P0205X C167414 CA
Pediatric Endocrinology Physician 2080P0205X ME165149 FL Primary
Pediatrics Physician 208000000X ME120252 FL

Addresses

Primary practice location

60 W Gore St
Orlando, FL 32806-1141

Mailing address

60 W Gore St
Orlando, FL 32806-1141
Phone (321) 843-1182

Other practice location 1

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 966-4032

Other practice location 2

13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone (407) 650-7210

Other identifiers 1

IdentifierTypeStateIssuer
012696700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20141220000346 FL Practitioner - Pediatric Medicine 1850614918 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C167414CAMDPediatrics Physician
ME165149FLMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Pediatrics CurrentSince May 1, 2024 Accepting new patients
The Nemours Foundation CurrentSince Nov 2, 2014 Accepting new patients
The Nemours Foundation CurrentSince Nov 2, 2014 Accepting new patients
Orlando Health Medical Group Inc CurrentSince May 1, 2024 Accepting new patients
The Nemours Foundation Current Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1717 S Orange Ave
Ste 100
Orlando, FL 32806

60 W Gore St
Orlando, FL 32806
Phone (321) 841-3338

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Organizations & group practices 5

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1992992432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-843-1182",
            "fax_number": "321-841-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-843-1182",
            "fax_number": "321-841-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-4032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13535 Nemours Pkwy",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277402",
            "country_code": "US",
            "telephone_number": "407-650-7210",
            "fax_number": "407-650-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA-VEGA",
        "first_name": "MICHELLE",
        "middle_name": "Y.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C167414",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME120252",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "C167414",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME165149",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME120252",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012696700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.