Kimberly Lissette Rivera, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

290 E St Apt 3
Boston, MA 02127-4668

Phone

(540) 322-7039

NPI assigned

Sep 12, 2019

Sex

Female

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 MA

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

Practice roles

Locations

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.

• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Brookline, MA
  • NPI 1720486830
  Medicare reassignment NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1609387695
  NPD

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1437709458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 E ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021274668",
            "telephone_number": "540-322-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021274668",
            "telephone_number": "540-322-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KIMBERLY",
        "middle_name": "LISSETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Adan Rivera, LCSW
• Desiree Rivera
• Iliali Rivera, LPC
• Javier Eduardo Rivera, ACAGNP
• Jillian Santos Rivera
• Marianella Rivera
• Nikolas W Rivera, PA
• Osvaldo Rivera, LADC I
• Rebecca Lynn Rivera, PT, DPT
• Ricardo A Rivera, M.D.

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.