NPIMap

Individual provider Active NPI

Simon Rivera

  • Physician Assistant
  • Midlothian, VA
National Provider Identifier
1700096963
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002952 Issued in VA
Practice address
13700 St. Francis Blvd
Emergency Medicine Department
Midlothian, VA 23114-3267
Phone
(804) 594-7950
Fax
(804) 594-0489
NPI assigned
May 23, 2007
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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 011817 NY
Physician Assistant 363A00000X 0110002952 VA Primary

Addresses

Primary practice location

13700 St. Francis Blvd
Emergency Medicine Department
Midlothian, VA 23114-3267

Mailing address

38935 Ann Arbor Road
Credentialing/Payer Contracting
Livonia, MI 48150-3397
Phone (734) 805-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000503 VA Practitioner - Physician Assistant 4082708383 Reassigns benefits to 4 organizations

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
Northern Virginia Carenow Urgent Care LLCGroup PAC ID 4284902057, 55 clinicians

Practice addresses (Care Compare)

12214 W Broad St
Henrico, VA 23233-1062
Phone (804) 362-8345

1380 N Parham Rd
Richmond, VA 23229-5742
Phone (804) 821-0010

46200 Potomac Run PLZ
Sterling, VA 20164-6622
Phone (571) 313-5087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011817NYMDPhysician Assistant
0110002952VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Better Outcomes LT Care LLC CurrentSince Sep 15, 2025 Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
One Hampton Medical, LLC Physician Assistant Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Montefiore Medical Center Past Accepting new patients
Professional Emergency Care, PC Physician Assistant Past Accepting new patients

Locations

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1700096963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR ROAD",
            "address_2": "CREDENTIALING/PAYER CONTRACTING",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-805-0477",
            "fax_number": "866-250-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 ST. FRANCIS BLVD",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143267",
            "telephone_number": "804-594-7950",
            "fax_number": "804-594-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SIMON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011817",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.