Individual provider Active NPI

Lourdes M Rivera, APRN

  • Family Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1912477027
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC004543 Issued in MD
Practice address
6480 Waterloo Rd
Elkridge, MD 21075-6508
Phone
(410) 799-0291
NPI assigned
Dec 1, 2018
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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 AC004543 MD Primary

Addresses

Primary practice location

6480 Waterloo Rd
Elkridge, MD 21075-6508

Mailing address

9601 Pulaski Park Dr Ste 417
Baltimore, MD 21220-1409
Phone (410) 933-5678

Other names 1

  • Lourdes Maria Rivera Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20221209000338 DC Practitioner - Nurse Practitioner 7012386261 Reassigns benefits to 1 organization
I20221209001951 MD Practitioner - Nurse Practitioner 7012386261 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Oct 13, 2022 Accepting new patients

Locations

2601 Riva Rd
Annapolis, MD 21401
Phone (410) 571-2090

10095 Ward Rd
Dunkirk, MD 20754
Phone (410) 257-0191

6480 Waterloo Rd
Elkridge, MD 21075
Phone (410) 799-0075

7955 Tuckerman Ln
Rockville, MD 20854
Phone (301) 299-3717

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1543622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1912477027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR STE 417",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 WATERLOO RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756508",
            "telephone_number": "410-799-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LOURDES",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC004543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOURDES",
            "last_name": "RIVERA",
            "middle_name": "MARIA",
            "credential": "AANP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.