Individual provider Active NPI

Angela Rivard, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1730176181
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN290911L Issued in PA
Practice address
2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542
Phone
(215) 952-9323
Fax
(215) 952-1246
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN290911L PA Primary

Addresses

Primary practice location

2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542

Mailing address

2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542
Phone (215) 952-9323

Other identifiers 1

IdentifierTypeStateIssuer
0019762810002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000685 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729021142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9323

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN290911LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jun 1, 1998 Accepting new patients
Methodist Associates in Healthcare, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 1998 Accepting new patients
Jefferson University Physicians CurrentSince Aug 4, 2019 Accepting new patients

Locations

2301 S Broad St
#1
Philadelphia, PA 19148

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

Organizations & group practices 4

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 1

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1730176181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9323",
            "fax_number": "215-952-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9323",
            "fax_number": "215-952-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "ANGELA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN290911L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019762810002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.