Individual provider Active NPI

Nesdi Rivera

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1265917264
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060176 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-1956
NPI assigned
Sep 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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 MA060176 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

37 Brewerytown CT
Philadelphia, PA 19121-4430
Phone (201) 478-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190110000510 PA Practitioner - Physician Assistant 2961748033 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 992-6002

4900 Frankford Ave
Philadelphia, PA 19124-2618
Phone (215) 612-5390

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physicain Services CurrentSince Jul 10, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Nov 7, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 8, 2024 Accepting new patients
Einstein Practice Plan Inc CurrentSince Nov 7, 2018 Accepting new patients
Aria Health Physician Services CurrentSince Jul 10, 2019 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

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

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 10

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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1265917264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BREWERYTOWN CT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191214430",
            "telephone_number": "201-478-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NESDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.