DOMINGO A RIVERA-LAKE PA
NPI 1225165319
Physician Assistant in Bronx, NY

Q: What is Domingo Rivera-lake's NPI number?

The NPI number for Domingo Rivera-lake is 1225165319. It was assigned to this individual provider in the NPPES registry on February 27, 2007.

Q: What is Domingo Rivera-lake's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since February 27, 2007PECOS Enrolled

111 E 210TH ST, MMC - DEPT OF RADIOLOGY, BRONX, NY 10467(866) 662-9729 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Domingo A Rivera-lake Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINGO A RIVERA-LAKE PA (NPI 1225165319) is an individual physician assistant in Bronx, New York, licensed in New York (009922) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225165319

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDOMINGO A RIVERA-LAKECredential: PA

Location Address111 E 210TH ST, MMC - DEPT OF RADIOLOGYBronx, NY 10467-2401

Mailing Address6 Dune Ct, Apt 1Bronx, NY 10473-1662 · (866) 662-9729 · Fax (718) 798-7983

Phone(866) 662-9729

Sole ProprietorNo

Enumeration DateFebruary 27, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1225165319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NY · 009922

Definition

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.

111 E 210TH ST, Bronx, NY 10467

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Domingo A Rivera-lake Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10467 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MADHU SHARMA MD

Pediatrics (Pediatric Cardiology)

111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467

Bronx County (718) 741-2538

DR. AMANDA MCNEAR JACOBS M.D.

Pediatrics (Adolescent Medicine)

111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467

Bronx County (718) 920-2306

HEATHER ROOT MD

Internal Medicine (Infectious Disease)