Individual provider Active NPI

Diana Rivera, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1568034783
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008477RX Issued in OH
Practice address
11590 Century Blvd Ste 102
Cincinnati, OH 45246-3317
Phone
(513) 648-9077
Fax
(513) 648-9554
NPI assigned
Jul 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 50.008477RX OH Primary

Addresses

Primary practice location

11590 Century Blvd Ste 102
Cincinnati, OH 45246-3317

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210928000229 NC Practitioner - Physician Assistant 1658778006
I20240913000301 OH Practitioner - Physician Assistant 1658778006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

11590 Century Blvd
Cincinnati, OH 45246-3326
Phone (513) 648-9077

2123 Auburn Ave
Cincinnati, OH 45219-2906

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • West Chester Hospital Hospital, West Chester, OH, CCN 360354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Physician Assistant CurrentSince Sep 3, 2024 Accepting new patients
University of Cincinnati Medical Center, LLC Physician Assistant Current Accepting new patients
University of Cincinnati Medical Center, LLC PastSince Jul 21, 2024 Accepting new patients

Locations

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

11590 Century Blvd
Ste 102
Cincinnati, OH 45246
Phone (513) 475-4825

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

11590 Century Blvd
Springdale, OH 45246
Phone (513) 648-9077

Interoperability endpoints

  • Direct secure messaging: dianarivera@cmm-nc.direct.office.nextgen.com

Organizations & group practices 3

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 3

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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1568034783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-6200",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11590 CENTURY BLVD STE 102",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463317",
            "telephone_number": "513-648-9077",
            "fax_number": "513-648-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008477RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.