Individual provider Active NPI

Andrea Michelle Rivers, ANP

  • Adult Health Nurse Practitioner
  • Wayne, NJ
National Provider Identifier
1881050458
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00600700 Issued in NJ
Practice address
645 Preakness Ave
Wayne, NJ 07470-2533
Phone
(973) 452-4674
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00600700 NJ Primary

Addresses

Primary practice location

645 Preakness Ave
Wayne, NJ 07470-2533

Mailing address

645 Preakness Ave
Wayne, NJ 07470-2533
Phone (973) 452-4674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20200204002112 NJ Practitioner - Nurse Practitioner 5092141358 Reassigns benefits to 2 organizations
I20240822002928 NY Practitioner - Nurse Practitioner 5092141358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Medical Care PCGroup PAC ID 2365705696, 54 clinicians

Practice addresses (Care Compare)

165 N Village Ave
Rockville Centre, NY 11570-3701
Phone (212) 803-3339

225 E 70TH St
Suite 1E
New York, NY 10021-5213
Phone (212) 803-3339

49 Veronica Ave
Suite 202
Somerset, NJ 08873-6802
Phone (212) 803-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00600700NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Medical Care PC Adult Health CurrentSince Jun 16, 2024 Accepting new patients
Rejuveinate LLC CurrentSince May 6, 2024 Accepting new patients
Ambulnz Co, LLC Current Accepting new patients
Fuse Medical PLLC CurrentSince Oct 1, 2024 Accepting new patients
Heart and Heart Rhythm Care, P.C. PastSince Dec 31, 2023 Accepting new patients
Fara Stricker Family Health Nurse Practitioner, P.C. PastSince May 14, 2023 Accepting new patients

Locations

127 Church Rd
Ste 600
Marlton, NJ 08053
Phone (856) 355-8582

49 Veronica Ave
Ste 202
Somerset, NJ 08873
Phone (732) 246-7600

175 Memorial Hwy
Ste 1-1
New Rochelle, NY 10801
Phone (914) 235-3535

225 E 70th St
Ste 1E
New York, NY 10021
Phone (212) 517-4660

30 Broad St
Ste 401
New York, NY 10004
Phone (212) 987-0100

115 Central Park W
Ofc 15
New York, NY 10023

120 E 56th St
Rm 300
New York, NY 10022
Phone (212) 920-3047

265 Sunrise Hwy
Ste 1274
Rockville Ctr, NY 11570

165 N Village Ave
Ste 133
Rockville Ctr, NY 11570
Phone (516) 764-0879

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1881050458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 PREAKNESS AVE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702533",
            "telephone_number": "973-452-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 PREAKNESS AVE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702533",
            "telephone_number": "973-452-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00600700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.