Wanda Rivera, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004972 Issued in NY

Practice address

128 Ashford Ave
Dobbs Ferry, NY 10522-1924

Phone

(914) 693-0700

Fax

(914) 693-4723

NPI assigned

Jan 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: wrivera69615@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1083892129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ASHFORD AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221924",
            "telephone_number": "914-693-0700",
            "fax_number": "914-693-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ASHFORD AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221924",
            "telephone_number": "914-693-0700",
            "fax_number": "914-693-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "WANDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Riccobono
• Glenn Riddick
• Diane Riefenhauser
• Anna Riolo, LMHC
• Steven Ritholtz, DDS
• Paulette Rivers, LCSW
• Rivertowns Pediatrics PC
• RLB Inc
• Laura Ann Roberts, PHD
• Angela M Robinson Giuffra, LCSW

• Physician Assistant in Dobbs Ferry, NY
• Providers in Dobbs Ferry, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.