Individual provider Active NPI

Nicole Marie Rivera

  • Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1619854486
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2740 NW 106TH Ave
Coral Springs, FL 33065-3717
Phone
(954) 850-3674
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2740 NW 106TH Ave
Coral Springs, FL 33065-3717

Mailing address

2740 NW 106TH Ave
Coral Springs, FL 33065-3717

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260609004537 FL Practitioner - Physician Assistant 6002387008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2740 NW 106TH Ave
Coral Springs, FL 33065-3717

752 Stirling Ctr PL
Suite 1008
Lake Mary, FL 32746

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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 4

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": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1619854486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 NW 106TH AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 NW 106TH AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653717",
            "telephone_number": "954-850-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.