Individual provider Active NPI

Craig Rivina

  • Physician Assistant
  • Lakewood, NY
National Provider Identifier
1699163147
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022362 Issued in NY
Practice address
390 E Fairmount Ave
Lakewood, NY 14750
Phone
(716) 526-0156
Fax
(716) 708-1578
NPI assigned
Jan 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA003464 PA
Physician Assistant 363A00000X MA057397 PA
Physician Assistant 363A00000X 022362 NY Primary

Addresses

Primary practice location

390 E Fairmount Ave
Lakewood, NY 14750

Mailing address

PO Box 500
Ellicottville, NY 14731-0500
Phone (716) 699-9032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, MI, OH, IL, IN, WI7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20150508000980 PA Practitioner - Physician Assistant 8325367634 Reassigns benefits to 1 organization
I20180905000656 NY Practitioner - Physician Assistant 8325367634 Reassigns benefits to 1 organization
I20211109000878 MI Practitioner - Physician Assistant 8325367634 Reassigns benefits to 2 organizations
I20211115002867 OH Practitioner - Physician Assistant 8325367634 Reassigns benefits to 1 organization
I20211124000031 IL Practitioner - Physician Assistant 8325367634 Reassigns benefits to 2 organizations
I20230320001516 IN Practitioner - Physician Assistant 8325367634 Reassigns benefits to 1 organization
I20230824002893 WI Practitioner - Physician Assistant 8325367634

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians
Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1009 Fairway Dr
Freeport, IL 61032-6600
Phone (815) 986-4200

1131 M 32
Alpena, MI 49707-8222
Phone (989) 250-1925

1233 Arsenal St
Watertown, NY 13601-2213
Phone (315) 221-5289

1711 W Hwy 50
O Fallon, IL 62269-1681
Phone (618) 206-5076

2524 N Illinois St
Swansea, IL 62226-2353
Phone (618) 212-3144

26 Bolivar Dr
Bradford, PA 16701-3125
Phone (814) 817-4690

3475 S Alpine Rd
Rockford, IL 61109-2604
Phone (815) 874-8000

391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411
Phone (630) 423-3030

416 S Milwaukee Ave
Libertyville, IL 60048-2821
Phone (847) 979-1112

4189 Veterans Memorial Dr
Batavia, NY 14020-1274
Phone (585) 201-5598

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

4995 Wintersweet Dr
Liverpool, NY 13088-2176
Phone (315) 401-3210

505 W Cleveland Rd
Mishawaka, IN 46545-1003
Phone (574) 235-3135

5495 Sheridan Dr
Buffalo, NY 14221-3609
Phone (716) 932-1198

573 N Greenbush Rd
Rensselaer, NY 12144-9451
Phone (518) 268-2345

655 E Dubois Ave
Du Bois, PA 15801-3605
Phone (814) 913-3097

6555 4TH Section Rd
Brockport, NY 14420-2441
Phone (585) 431-5364

6870 E Genesee St
Fayetteville, NY 13066-1031
Phone (315) 679-4367

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

917 S Saint Marys St
Saint Marys, PA 15857-2828
Phone (814) 389-1026

924 W Pike St
Physicians Urgent Care
Goshen, IN 46526-2365
Phone (574) 312-7056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022362NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Nov 1, 2021 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Nov 1, 2021 Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients

Locations

1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

6012 S Westnedge Ave
Portage, MI 49002
Phone (269) 220-8950

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066

Organizations & group practices 7

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1699163147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "ELLICOTTVILLE",
            "state": "NY",
            "postal_code": "147310500",
            "telephone_number": "716-699-9032",
            "fax_number": "716-699-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E FAIRMOUNT AVE",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "14750",
            "telephone_number": "716-526-0156",
            "fax_number": "716-708-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVINA",
        "first_name": "CRAIG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003464",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NY

Sources for this page

Verify at the official NPI Registry.