Shanelly Rivas, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12210010 Issued in FL

Practice address

1239 Meissen Ave NW
Palm Bay, FL 32907-1037

Phone

(321) 525-6476

NPI assigned

Dec 11, 2021

Sex

Female

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srivas71396@epicdirect.hf.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.

• Srinivas Dontineni MD PA

  dba Brevard Hospitalist Associates

  • Infectious Disease Physician
  • Cocoa, FL
  • NPI 1639323041
  Medicare reassignment NPD

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639180800000",
    "number": "1447919030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 MEISSEN AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071037",
            "telephone_number": "321-525-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 MEISSEN AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071037",
            "telephone_number": "321-525-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "SHANELLY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-11",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F12210010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Richardson, D.C.
• Nathan Richardson
• Gillian Ridge-Canoy, M.S., BCABA
• William E. Riebsame, PH.D.
• Linda Riley, PH.D.
• Ashley Paola Rivera Roman, PHARMD
• Garion Rivera
• Sully Rivera, MA
• Rivers Edge Adult Day Care Incorporated
• Road Runner Medical Supplies

• Family Nurse Practitioner in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; 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.