Active NPI
Matthew Aaron Rivadeneira
- Physician Assistant
- Valley Stream, NY
National Provider Identifier
1861200990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 036404
- Practice address
- 28 Lynwood Dr
Valley Stream, NY 11580-3327 - Phone
- (516) 660-4148
- NPI assigned
- Dec 20, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 036404 | NY | Primary |
Addresses
Primary practice location
28 Lynwood Dr
Valley Stream, NY 11580-3327
Mailing address
28 Lynwood Dr
Valley Stream, NY 11580-3327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1861200990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 LYNWOOD DR",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115803327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 LYNWOOD DR",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115803327",
"telephone_number": "516-660-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVADENEIRA",
"first_name": "MATTHEW",
"middle_name": "AARON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-20",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "036404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.