EDUARDO G RIVERA (NPI# 1457428096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457428096 |
| Entity Type | Individual |
| Full Name | EDUARDO G RIVERA |
| Credential | M.D. |
| Practice Address |
122 Demaree Dr Madison IN 47250-4622 |
| Practice Telephone | 8122659191 |
| Practice Fax Number | 8122651050 |
| Mailing Telephone | 8122659191 |
| Mailing Fax Number | 8122651050 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-12-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
01050279 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | IN HEALTH NETWORK ID | 20897 | 01 |
| IN | COLUMBUS SIHO ID | 065504 | 01 |
| KY | 50007573 | 05 | |
| IN | ANTHEM BCBS IN PROV NUMB | 000000368119 | 01 |
| IN | AETNA PROVIDER NUMBER | 7514003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841566700 | Eduardo Rivera | Pathology | 2920 Bloomfield Shore Drive, West Bloomfield, MI 48323 | 2012-03-26 |
| Street Address |
122 DEMAREE DR |
| City | MADISON |
| State | IN |
| Zip Code | 47250-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518983188 | Michelle A Hannigan | Nurse Practitioner | 122 Demaree Dr, Madison, IN 47250-4622 | 2006-07-15 |
| 1861653214 | Shelley Marie Schuler | Physician Assistant | 122 Demaree Dr, Madison, IN 47250-4622 | 2008-06-18 |
| 1245430362 | Karma A Kristufek | Physician Assistant | 122 Demaree Dr, Madison, IN 47250-4622 | 2007-07-18 |
| 1437225596 | Deborah Roese | Physician Assistant | 122 Demaree Dr, Madison, IN 47250-4622 | 2006-11-28 |
| 1215007455 | Madison Dermatology LLC | Dermatology | 122 Demaree Dr, Madison, IN 47250-4622 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196842 | Ariel C Breaux | Psychologist | 800 Bus Stop Dr, Madison, IN 47250 | 2020-08-28 |
| 1801314455 | Physicians Medical Center LLC | Nurse Practitioner | 311 E Clifty Drive, Madison, IN 47250 | 2017-09-05 |
| 1205201381 | Harrison County Hospital | Skilled Nursing Facility | 120 Presbyterian Avenue, Madison, IN 47250 | 2015-12-01 |
| 1720425796 | Kellie Robinson | Physical Therapist | 112 Holt Dr., Madison, IN 47250 | 2013-05-30 |
| 1568761575 | Linda Wehner D.m.d. LLC | Dentist | 1105 Clifty Drive, Madison, IN 47250 | 2011-03-17 |
| 1205142221 | Mary-caroline Peddie | Registered Nurse | 2003 Hycliff Ct, Madison, IN 47250 | 2010-08-27 |
| 1235376625 | Brian Edward Armbrecht | Pharmacist | One King's Daughters' Dr, Madison, IN 47250 | 2009-01-07 |
| 1902092661 | Assisted Living Concepts Inc | Assisted Living Facility | 607 Virginia Avenue, Madison, IN 47250 | 2007-09-17 |
| 1831218262 | Voca of Indiana LLC | Intermediate Care Facility, Mentally Retarded | 3004 Kentucky Ave, Madison, IN 47250 | 2007-03-28 |
| 1396877205 | Quinco Consulting Center Inc | Clinic/Center | 3100 N Bevcher Drive, Madison, IN 47250 | 2007-03-09 |
| Find all providers in zip 47250 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366583882 | Albert Earl Rivera | Dermatology | 8331 Madison Blvd, Suite 300, Madison, AL 35758-2070 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1780137232 | Forefront Dermatology, S.c. | Dermatology | 265 Quartermaster Ct, Jeffersonville, IN 47130 | 2016-08-02 |
| 1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
| 1144680604 | Forefront Dermatology, S.c. | Dermatology | 244 Westwood Blvd, Columbus, IN 47201 | 2016-02-26 |
| 1730560079 | Forefront Dermatology, S.c. | Dermatology | 415 S Landmark Ave, Bloomington, IN 47403-5003 | 2015-06-12 |
| 1295771244 | Carl William Hanke | Dermatology | 8925 N Meridian St Ste 200, Indianapolis, IN 46260-2385 | 2006-06-20 |
| 1821574039 | Michael Kunz | Dermatology | 545 Barnhill Drive, Emerson Hall 139, Indianapolis, IN 46202 | 2018-07-11 |
| 1952769044 | Forefront Dermatology, S.c. | Dermatology | 755 W Carmel Dr, Suite 101, Carmel, IN 46032 | 2016-02-03 |
| 1417335019 | Forefront Dermatology, S.c. | Dermatology | 395 Northside Dr, Batesville, IN 47006 | 2015-05-14 |
| 1235534629 | Forefront Dermatology, S.c. | Dermatology | 8325 S Emerson Ave Ste C1, Indianapolis, IN 46237 | 2014-10-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.