JOHAN ERNESTO RIVERA PA
NPI 1568249969
Physician Assistant in Round Rock, TX

Q: What is Johan Rivera's NPI number?

The NPI number for Johan Rivera is 1568249969. It was assigned to this individual provider in the NPPES registry on September 11, 2023.

Q: What is Johan Rivera's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Johan Rivera was last updated on October 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2023PECOS EnrolledAccepts Medicare Assignment

3950 N A W GRIMES BLVD STE N201, ROUND ROCK, TX 78665(877) 800-5722 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Johan Ernesto Rivera Pa NPPES

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

JOHAN ERNESTO RIVERA PA (NPI 1568249969) is an individual physician assistant in Round Rock, Texas, licensed in Texas (PA17137) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS, is affiliated with Ascension Seton Medical Center Austin, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1568249969

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJOHAN ERNESTO RIVERACredential: PA

Location Address3950 N A W GRIMES BLVD STE N201Round Rock, TX 78665-3540

Mailing Address205 E University Ave Ste 200Georgetown, TX 78626-6821 · (512) 994-1933

Phone(877) 800-5722

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateSeptember 11, 2023

Last NPPES UpdateOctober 5, 2023

NPPES CertifiedOctober 5, 2023

✔ NPI 1568249969 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 TX · PA17137

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.

3950 N A W GRIMES BLVD STE N201, Round Rock, TX 78665

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Johan Ernesto Rivera Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456707918

PECOS Enrollment IDI20231019003672

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Seton Medical Center Austin

Acute Care Hospitals · Austin, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450056

Location1201 W 38th StAustin, TX 78705 · Travis County

Emergency services Birthing friendly

Northwest Hills Surgical Hospital

Acute Care Hospitals · Austin, TX

OwnershipVoluntary non-profit - Private

CMS Certification Number450808

Location6818 Austin Ctr Blvd Suite 100Austin, TX 78731 · Travis County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78665 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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 7

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

PRIYA CHANDNA RN

Nurse Practitioner (Pediatrics)