Individual provider Active NPI

Nathalie Jaqueline Rivera, PA-C

  • Physician Assistant
  • Elizabeth, NJ
National Provider Identifier
1861099145
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00584800 Issued in NJ
Practice address
225 Williamson St
Elizabeth, NJ 07202-3625
Phone
(908) 994-5000
Fax
(732) 923-2272
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 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 025675-01 NY
Physician Assistant 363A00000X 25MP00584800 NJ Primary

Addresses

Primary practice location

225 Williamson St
Elizabeth, NJ 07202-3625

Mailing address

555 Ramapo Valley Rd
Oakland, NJ 07436-2817
Phone (201) 463-4491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20201215000368 NY Practitioner - Physician Assistant 8325450422 Reassigns benefits to 1 organization
I20211124001340 NJ Practitioner - Physician Assistant 8325450422 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians
Gold Standard Medical Group PCGroup PAC ID 2961762554, 32 clinicians

Practice addresses (Care Compare)

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5422

865 Stone St
Rahway, NJ 07065-2742
Phone (732) 381-4200

992 Clifton Ave
Clifton, NJ 07013-3502
Phone (201) 839-5016

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital at Rahway Hospital, Rahway, NJ, CCN 310024

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025675-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Georgia Inc CurrentSince Aug 13, 2021 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

Organizations & group practices 8

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": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1861099145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 RAMAPO VALLEY RD",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362817",
            "telephone_number": "201-463-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "908-994-5000",
            "fax_number": "732-923-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NATHALIE",
        "middle_name": "JAQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025675-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00584800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.