MANUEL A. RIVERA M.D.
NPI 1184690133
Internal Medicine in Kenosha, WI
NPI Status: Active since February 28, 2006
Contact Information
4536 22ND AVE
KENOSHA, WI
ZIP 53140
Phone: (262) 656-0044
Fax: (262) 653-2218
- Individual
- Male
- Years of Experience 43
- Internal Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About MANUEL RIVERA
This page provides the complete NPI Profile along with additional information for Manuel Rivera, an internist established in Kenosha, Wisconsin with a medical specialization in Internal Medicine and more than 43 years of experience. He graduated from University Of Texas Southwestern Medical School At Dallas in 1983. The healthcare provider is registered in the NPI registry with number 1184690133 assigned on February 2006. The practitioner's primary taxonomy code is 207R00000X with license number 26699 (WI). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1184690133
- Provider Name
- MANUEL A. RIVERA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4536 22ND AVE KENOSHA, WI 53140
- Location Phone
- (262) 656-0044
- Location Fax
- (262) 653-2218
- Mailing Address
- 4006 WASHINGTON RD KENOSHA, WI 53144
- Mailing Phone
- (262) 656-0044
- Mailing Fax
- (262) 653-2218
- Medical School Name
- UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
- Graduation Year
- 1983
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-28-2006
- Last Update Date
- 06-30-2023
- Code Navigator
An internist like Manuel Rivera is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 5000 Memorial Dr
Two Rivers, WI 54241
(920) 794-5000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 26699
- License State
- WI
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207PE0004X | Allopathic & Osteopathic Physicians | Emergency Medicine | H0762 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Chorus Bronze Complete - EPO
- Chorus Bronze HDHP - EPO
- Chorus Catastrophic - EPO
- Chorus Core Bronze - EPO
- Chorus Core Gold - EPO
- Chorus Core Silver - EPO
- Chorus Elite Gold - EPO
- Chorus Gold - EPO
- Chorus Silver - EPO
- Chorus Silver Select - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
- CGHC Gold Standard $1500 - Envision Network - EPO
- CGHC Gold Standard $1500 - Envision Network (Vision Exam) - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver Standard $5000 - Envision Network - EPO
- CGHC Silver Standard $5000 - Envision Network (Vision Exam) - EPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Manuel Rivera is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Manuel Rivera is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 749251874
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20060217000556
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 53140 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $123.69
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $30.92
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 8 | 4 | 6 | 9 | 0 | 1 | 3 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 16 | 4 | 12 | 9 | 0 | 1 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 6 + 4 + 1 + 2 + 9 + 0 + 1 + 6 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1184690133 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1265435960 | KENOSHA COMMUNITY HEALTH CENTER INC Organization | Clinic/Center (Community Health) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1578550521 | DR. TONI M ROUCKA DDS Individual | Dentist (General Practice) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1114914066 | DR. HAZEL E MOORE DDS Individual | Dentist (General Practice) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1023005972 | DR. CESAR D GONZALEZ DDS Individual | Dentist (Pediatric Dentistry) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1811062581 | JENNIFER R CONNOLLY RDH Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1952476632 | LISA SUE RISTAU RDH Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1043466196 | DIANE E KOSAR Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1851549935 | KATHLEEN MARIE FLINT Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1790012508 | MS. JODI NEISES DENTAL HYGENIST Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1821326208 | MS. TONI MARIE PARISE DENTAL HYGIENIST Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1558699926 | MS. KELLY A REEVES DENTAL HYGIENIST Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1578894820 | SUZANNE K OTTO DENTAL HYGENIST Individual | Dental Hygienist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1316296171 | EMILY JANE COLLINS R.D. Individual | Dietitian, Registered | 4536 22ND AVE KENOSHA, WI 53140 (262) 646-0044 |
| 1356605323 | MS. DOMINIQUE SHANTELLE PRITCHETT LCSW Individual | Social Worker (Clinical) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1407294937 | DAVID T MARX PSY.D. Individual | Psychologist | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1124213954 | DR. MICHAEL MATTHEW MIHAJLOVIC PSYD Individual | Psychologist (Clinical) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1316345416 | ANGELA MARTIN LPC Individual | Counselor (Professional) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1588037691 | JULIE PERRAULT Individual | Counselor (Professional) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1265978878 | MELISSA PESTKA Individual | Nurse Practitioner (Family) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
| 1336798685 | KRYSTAL MARIE RAFENSTEIN APNP, FNP-BC Individual | Nurse Practitioner (Family) | 4536 22ND AVE KENOSHA, WI 53140 (262) 656-0044 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184690133, enumerated in the NPI registry as an "individual" on February 28, 2006
The provider is located at 4536 22nd Ave Kenosha, Wi 53140 and the phone number is (262) 656-0044
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 43 years of experience. He graduated from University Of Texas Southwestern Medical School At Dallas in 1983.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $123.69 with an average copayment of $30.92 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on February 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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