Individual provider Active NPI

Jill Marie Rivas, FNP

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1689089823
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000860 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 521-6097
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000860 CA Primary

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151110003072 CA Practitioner - Nurse Practitioner 1456661016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

815 Court St
Jackson, CA 95642-2154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95000860CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

924 S Fairmont Ave
Lodi, CA 95240
Phone (209) 334-2590

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jrivas92615@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1689089823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.