MRS. GINA RIVAS PA-C
NPI 1164933503
Physician Assistant in Prosper, TX

NPI Status: Active since October 12, 2017

Contact Information

4150 SILVER SPUR DR
PROSPER, TX
ZIP 75078
Phone: (432) 978-8844

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  • Individual
  • Female
  • Physician Assistant
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About GINA RIVAS

This page provides the complete NPI Profile along with additional information for Gina Rivas, a primary care provider established in Prosper, Texas with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1164933503 assigned on October 2017. The practitioner's primary taxonomy code is 363A00000X with license number PA11603 (). The provider is registered as an individual and her NPI record was last updated May 2026.

NPI
1164933503
Provider Name
MRS. GINA RIVAS PA-C
Gender
Female
Entity Type
Individual
Location Address
4150 SILVER SPUR DR PROSPER, TX 75078
Location Phone
(432) 978-8844
Mailing Address
4150 SILVER SPUR DR PROSPER, TX 75078
Mailing Phone
(432) 978-8844
Is Sole Proprietor?
No
Enumeration Date
10-12-2017
Last Update Date
05-22-2026
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A primary care provider (PCP) like Gina Rivas sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 255 W Lebanon Ste 132
    Frisco, TX 75036
    (469) 210-4400
  • 255 W Lebanon Ste 132
    Frisco, TX 75036
    (469) 210-4400

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA11603
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic - EPO
  • Gold Classic Guided Care - HMO
  • Gold Classic Standard - EPO
  • Gold Classic Standard Guided Care - HMO
  • Gold Elite - EPO
  • Gold Simple Diabetes Guided Care - HMO
  • Gold Simple Guided Care - HMO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard Guided Care - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care - HMO
  • Silver Simple Chronic Care CKM Guided Care - HMO
  • Silver Simple Diabetes Guided Care - HMO
  • Silver Simple Guided Care - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Gina Rivas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    3 DME suppliers used 76 Medicare Claims 76 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    2 DME suppliers used 55 Medicare Claims 55 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    2 DME suppliers used 58 Medicare Claims 166 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    2 DME suppliers used 13 Medicare Claims 75 Services Paid

  • DME-Other DME (DE001N)

    Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

    1 DME suppliers used 19 Medicare Claims 114 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    1 DME suppliers used 28 Medicare Claims 28 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    2 DME suppliers used 48 Medicare Claims 48 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    3 DME suppliers used 82 Medicare Claims 479 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    2 DME suppliers used 34 Medicare Claims 34 Services Paid

  • DME-Other DME (DE001N)

    Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 72 Medicare Claims 72 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 75078 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.92
  • Minimum New Patient Price $54.84
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $21.23
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.55
  • Minimum Established Patient Price $17.52
  • Maximum Established Patient Price $136.11
  • Average Established Patient Copayment $17.13
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
e-Prescribing 82% 270
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Patient-Specific Education 5% 20
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 75% 20
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 30% 20
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164933503, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
0
Doubled → 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 3 → 6 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 1 + 8 + 3 + 6 + 5 + 0 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1164933503.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164933503, enumerated as an "individual" on October 12, 2017.

The provider is located at 4150 SILVER SPUR DR PROSPER, TX 75078 and the phone number is (432) 978-8844.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Oscar Insurance Company. Please consult your insurance carrier or call the provider to verify.