Johan Ernesto Rivera, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17137 Issued in TX

Practice address

3950 N a W Grimes Blvd Ste N201
Round Rock, TX 78665-3540

Phone

(877) 800-5722

NPI assigned

Sep 11, 2023

Last updated

Oct 5, 2023By 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 TX

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Hills Surgical Hospital Hospital, Austin, TX, CCN 450808
• Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056
• Ascension Seton Hays Hospital, Kyle, TX, CCN 670056

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johan.rivera.1@8363.direct.athenahealth.com
• Direct secure messaging: johan.rivera.p1@direct.lscctx.nextgenshare.com

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.

• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  Medicare reassignment Care Compare group NPD
• Seton Family of Doctors

  dba Ascension Texas Imaging

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD
• Lone Star Circle of Care

  dba Lone Star Circle of Care at Georgetown Dental

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1639129331
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Seton

  dba Ascension Seton Medical Center Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1164526786
  Care Compare affiliation
• Ascension Seton

  dba Ascension Seton Hays

  • General Acute Care Hospital
  • Kyle, TX
  • NPI 1619115383
  Care Compare affiliation
• Austin Center for Outpatient Surgery LP

  dba Northwest Hills Surgical Hospital

  • Special Hospital
  • Austin, TX
  • NPI 1245292630
  Care Compare affiliation

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1568249969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE STE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266821",
            "telephone_number": "512-994-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 N A W GRIMES BLVD STE N201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653540",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JOHAN",
        "middle_name": "ERNESTO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Rios, PHARM.D
• Gavin Ritchie, APRN
• Mabeli Rivas
• Marlie Rivera Cantillo
• Dorissa R Rivera, CRNA
• Maricruz Rivera, MD, PHD
• Vanessa Rene Rivera
• Salvatore Edward Rivoli
• Rma Medical Services, PLLC (Express Urgent Care)
• Road Towards Success

• Physician Assistant in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.
• 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.