Individual provider Active NPI

Miriannys Rivas, FNP-C

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1790240141
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN02001 Issued in RI
Practice address
655 Broad St Ste 201
Providence, RI 02907-1444
Phone
(401) 390-0734
NPI assigned
Feb 8, 2019
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 APRN02001 RI Primary

Addresses

Primary practice location

655 Broad St Ste 201
Providence, RI 02907-1444

Mailing address

655 Broad St Ste 201
Providence, RI 02907-1444
Phone (401) 642-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20200727002991 RI Practitioner - Nurse Practitioner 5698199495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Wellness Connect Go Beyond Medicine LLCGroup PAC ID 7517381312, 3 clinicians

Practice addresses (Care Compare)

655 Broad St
Suite 201
Providence, RI 02907-1444
Phone (401) 642-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN02001RIMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: miriannys.rivas.1@22477.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1790240141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BROAD ST STE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071444",
            "telephone_number": "401-642-0100",
            "fax_number": "833-992-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 BROAD ST STE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071444",
            "telephone_number": "401-390-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "MIRIANNYS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN02001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.