Keiley Cornell Indivero, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1285060657 Issued in NJ

Practice address

355 Grand St
Jersey City, NJ 07302-4321

Phone

(315) 915-2000

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

Merit-based Incentive Payment System (MIPS)

Final score

87.07 of 100Reported as group

Quality

76.5

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.87

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kindivero45270@epicdirect.rwjbh.org

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.

• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806

  NJ

  Medicare reassignment Care Compare group
• Rwjbh Emergency Medicine Associates, LLC

  • Emergency Medicine Physician
  • Somerset, NJ
  • NPI 1912510041

  NJ

  Medicare reassignment

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

• Jersey City Medical Center

  • General Acute Care Hospital
  • Jersey City, NJ
  • NPI 1689744856

  Hospital

  Care Compare affiliation
• Jersey City Medical Center

  • Ambulance
  • Jersey City, NJ
  • NPI 1871738021

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1285060657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "315-915-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "315-915-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDIVERO",
        "first_name": "KEILEY",
        "middle_name": "CORNELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "1285060657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Imm
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• Immersed Therapies
• Imperial Shoe Store Co Inc
• In-Balance Psychotherapy
• Infusionx Clinics PC
• Innercalm Wellness NJ PC
• Inserra Supermarkets Inc.
• Institute for Better Breathing PC
• Institute for Peace and Transformative Healing a NJ Nonprofit Corporat

• All providers in Jersey City, NJ
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.