Physician Compare National (NPI:1669432209)

HEALTHCARE PROVIDER: RAFAEL RIVERA-RIVERA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1669432209
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456368794
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071115000600
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RIVERA RIVERA
	Individual professional last name
Provider First Name	RAFAEL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PULMONARY DISEASE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE, PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	CRITICAL CARE SPECIALISTS OF NORTH TEXAS PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4880827104
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1208 BROOK AVE
	Group Practice or individual's line 1 address
City	WICHITA FALLS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	763015602
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9403224480
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450010
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNITED REGIONAL HEALTH CARE SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450827
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	KELL WEST REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y