Individual provider Active NPI

Amy R Rivera, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1306236435
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN3073412 Issued in FL
Practice address
2954 Mallory Cir Ste 200
Kissimmee, FL 34747-1822
Phone
(689) 207-0654
Fax
(407) 396-1028
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN3073412 FL Primary

Addresses

Primary practice location

2954 Mallory Cir Ste 200
Kissimmee, FL 34747-1822

Mailing address

2954 Mallory Cir Ste 200
Kissimmee, FL 34747-1822
Phone (689) 207-0654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150423001198 FL Practitioner - Nurse Practitioner 9739407792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

2831 Maguire Rd
Windermere, FL 34786-6057
Phone (866) 389-2727

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Nov 13, 2024 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

2831 Maguire Rd
Windermere, FL 34786
Phone (407) 654-0568

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1306236435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2954 MALLORY CIR STE 200",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347471822",
            "telephone_number": "689-207-0654",
            "fax_number": "407-396-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2954 MALLORY CIR STE 200",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347471822",
            "telephone_number": "689-207-0654",
            "fax_number": "407-396-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN3073412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.