Individual provider Active NPI

Vanessa Rene Rivera

  • Gerontology Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1417735523
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1123744 Issued in TX
Practice address
2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone
(512) 244-4272
Fax
(512) 244-2895
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1123744 TX
Primary Care Nurse Practitioner 363LP2300X 1123744 TX
Gerontology Nurse Practitioner 363LG0600X 1123744 TX Primary

Addresses

Primary practice location

2000 S Mays St Ste 201
Round Rock, TX 78664-7580

Mailing address

101 W Louis Henna Blvd Ste 300
Austin, TX 78728-1203
Phone (512) 244-4272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231107000265 TX Practitioner - Nurse Practitioner 5698122075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Geriatric Specialists PLLCGroup PAC ID 5092770511, 59 clinicians

Practice addresses (Care Compare)

11406 Rustic Rock Dr
Austin, TX 78750-3505
Phone (512) 477-4088

Hospital & facility affiliations

  • Capitol Home Health Home health agency, Austin, TX, CCN 747581
  • Enhabit Home Health Home health agency, San Antonio, TX, CCN 679044

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1123744TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Geriatric Specialists, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Hni Medical Services Past Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • Direct secure messaging: vanessa.rivera.1@25850.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1417735523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "VANESSA",
        "middle_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1123744",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1123744",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1123744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.