Individual provider Active NPI

Nina Rivera

  • Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1215792114
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010524 Issued in IL
Practice address
85 W Algonquin Rd Ste 220
Arlington Heights, IL 60005-4423
Phone
(847) 381-8899
NPI assigned
Feb 19, 2024
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.010524 IL Primary

Addresses

Primary practice location

85 W Algonquin Rd Ste 220
Arlington Heights, IL 60005-4423

Mailing address

85 W Algonquin Rd Unit 250
Arlington Heights, IL 60005-4422

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nrivera@directaddress.net
FHIR URL https://select.nextech-api.com/api

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001940 IL Practitioner - Physician Assistant 9133667660

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 N Randall Rd
Suite 400
Elgin, IL 60123-7803

1600 N Randall Rd
Suite 400
Elgin, IL 60123-7805

PO Box
Carol Stream, IL 60197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.010524ILMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1215792114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W ALGONQUIN RD UNIT 250",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W ALGONQUIN RD STE 220",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054423",
            "telephone_number": "847-381-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrivera@directaddress.net",
            "affiliation": "N",
            "address_1": "85 W Algonquin Rd Ste 220",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600054423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://select.nextech-api.com/api",
            "affiliation": "N",
            "address_1": "85 W Algonquin Rd Ste 220",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600054423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.