Individual provider Active NPI

Edelisse V. Rivera, CRNA

  • Certified Registered Nurse Anesthetist
  • Maitland, FL
National Provider Identifier
1487254470
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11011140 Issued in FL
Practice address
500 Winderley PL Ste 115
Maitland, FL 32751-7406
Phone
(407) 581-9180
Fax
(865) 560-7066
NPI assigned
Oct 28, 2020
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11011140 FL Primary

Addresses

Primary practice location

500 Winderley PL Ste 115
Maitland, FL 32751-7406

Mailing address

500 Winderley PL Ste 115
Maitland, FL 32751-7406
Phone (407) 581-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001483 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496169740 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

201 14TH St SW
Largo, FL 33770-3133
Phone (727) 588-5200

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Mar 1, 2021 Accepting new patients
SMH Physician Services Inc CurrentSince Jul 17, 2023 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Jun 1, 2021 Accepting new patients
Baycare Medical Group, Inc CurrentSince Jul 28, 2025 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 8, 2022 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jul 28, 2025 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

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.

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": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1487254470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "407-581-9180",
            "fax_number": "865-560-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "407-581-9180",
            "fax_number": "865-560-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EDELISSE",
        "middle_name": "V.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11011140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.