Individual provider Active NPI

Mary Rivera, NP

  • Nurse Practitioner
  • Johnson City, NY
National Provider Identifier
1215912704
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
301728 Issued in NY
Practice address
52 Harrison St
Southern Tier Pulmonary
Johnson City, NY 13790-2120
Phone
(607) 729-8845
Fax
(607) 729-5574
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 301728 NY Primary

Addresses

Primary practice location

52 Harrison St
Southern Tier Pulmonary
Johnson City, NY 13790-2120

Mailing address

52 Harrison St
Southern Tier Pulmonary
Johnson City, NY 13790-2120
Phone (607) 729-8845

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080123000564 NY Practitioner - Nurse Practitioner 4082796529 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

179 N Broad St
Uhs Senior Living Norwich
Norwich, NY 13815-1019
Phone (607) 337-4111

Hospital & facility affiliations

  • Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
78.3
Promoting interoperability
100
Improvement activities
40
Cost
72.17

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
86.36
Promoting interoperability
99
Improvement activities
40
Cost
79.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Pulmonary & Critical Care Medicine LLC CurrentSince Oct 1, 2006 Accepting new patients
Chenango Memorial Hospital Inc CurrentSince May 20, 2016 Accepting new patients
United Medical Associates PC CurrentSince Apr 25, 2017 Accepting new patients
Chenango Memorial Hospital Inc Current Accepting new patients
United Medical Associates, P.C. CurrentSince Apr 25, 2017 Accepting new patients
Chenango Memorial Hospital, Inc. Nurse Practitioner CurrentSince May 20, 2016 Accepting new patients
Delaware Valley Hospital, Inc Past Accepting new patients

Locations

52 Harrison St
Johnson City, NY 13790
Phone (607) 729-8845

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

52 Harrison St
#1
Johnson City, NY 13790
Phone (607) 729-8845

179 N Broad St
Norwich, NY 13815
Phone (607) 337-4111

Organizations & group practices 7

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 2

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1215912704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 HARRISON ST",
            "address_2": "SOUTHERN TIER PULMONARY",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902120",
            "telephone_number": "607-729-8845",
            "fax_number": "607-729-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 HARRISON ST",
            "address_2": "SOUTHERN TIER PULMONARY",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902120",
            "telephone_number": "607-729-8845",
            "fax_number": "607-729-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "301728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.