Individual provider Active NPI

Eliza Lynn Rivera, PT,DPT,WCS

  • Orthopedic Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1245617315
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 23199 Issued in FL
Practice address
4555 Emerson St
Suite # 220
Jacksonville, FL 32207-4966
Phone
(904) 633-0140
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 23199 FL Primary

Addresses

Primary practice location

4555 Emerson St
Suite # 220
Jacksonville, FL 32207-4966

Mailing address

4555 Emerson St
Suite # 220
Jacksonville, FL 32207-4966
Phone (904) 633-0140

Other names 1

  • Eliza Lynn Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605002937 FL Practitioner - Physical Therapist in Private Practice 2365763067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32231-6511
Phone (904) 244-6340

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 23199FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Feb 14, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2015 Accepting new patients

Locations

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

4555 Emerson St
Ste 220
Jacksonville, FL 32207
Phone (904) 633-0100

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1245617315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 EMERSON ST",
            "address_2": "SUITE # 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074966",
            "telephone_number": "904-633-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 EMERSON ST",
            "address_2": "SUITE # 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074966",
            "telephone_number": "904-633-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ELIZA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PT,DPT,WCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT 23199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "JOHNSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.