Cristobal N Rivera, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

01101 Issued in WV

Practice address

91 Pine Street
Franklin, WV 26807

Phone

(304) 263-0811

Fax

(304) 358-3641

NPI assigned

Sep 1, 2006

Last updated

Feb 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridgeport Express Care Inc

  • General Practice Physician
  • Bridgeport, WV
  • NPI 1912142001
  Medicare reassignment

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1427150598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1380",
            "city": "FRANKLIN",
            "state": "WV",
            "postal_code": "268071380",
            "telephone_number": "304-263-0811",
            "fax_number": "304-358-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 PINE STREET",
            "city": "FRANKLIN",
            "state": "WV",
            "postal_code": "26807",
            "telephone_number": "304-263-0811",
            "fax_number": "304-358-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "CRISTOBAL",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Dawn Prevatte
• Carolyn J Propst
• Daniel Propst
• Clona Rader
• Carmen R Rexrode, MD
• Rooted Therapy LLC
• RSCR West Virginia, Inc
• Patricia Joanne Ruddle
• Shirley Ruddle
• Linda Ryan

• Physician Assistant in Franklin, WV
• Providers in Franklin, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.