Individual provider Active NPI

Melissa Rivera, PA-C

  • Medical Physician Assistant
  • Huntingdon Valley, PA
National Provider Identifier
1124424668
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA003378 Issued in PA
Practice address
727 Welsh Rd
Suite 103
Huntingdon Valley, PA 19006-6310
Phone
(215) 947-7550
NPI assigned
Nov 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA003378 PA Primary

Addresses

Primary practice location

727 Welsh Rd
Suite 103
Huntingdon Valley, PA 19006-6310

Mailing address

727 Welsh Rd
Suite 103
Huntingdon Valley, PA 19006-6310
Phone (215) 947-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150901001636 PA Practitioner - Physician Assistant 5890001168 Reassigns benefits to 3 organizations
I20240523002416 NJ Practitioner - Physician Assistant 5890001168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Lall Orthopedics LLCGroup PAC ID 0749666410, 3 clinicians

Practice addresses (Care Compare)

140 N Rte
17 Suite 321
Paramus, NJ 07652-2817
Phone (716) 998-2560

Hospital & facility affiliations

  • Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA003378PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Feb 24, 2018 Accepting new patients
Einstein Practice Plan Inc CurrentSince Feb 24, 2018 Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1124424668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 WELSH RD",
            "address_2": "SUITE 103",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066310",
            "telephone_number": "215-947-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 WELSH RD",
            "address_2": "SUITE 103",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066310",
            "telephone_number": "215-947-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon Valley, PA

Sources for this page

Verify at the official NPI Registry.