JOHAN ERNESTO RIVERA PA
NPI 1568249969
Physician Assistant in Round Rock, TX
NPI Status: Active since September 11, 2023
Contact Information
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
Phone: (877) 800-5722
- Individual
- Male
- Years of Experience 4
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOHAN RIVERA
This page provides the complete NPI Profile along with additional information for Johan Rivera, a primary care provider established in Round Rock, Texas with a medical specialization in Physician Assistant and more than 4 years of experience. The healthcare provider is registered in the NPI registry with number 1568249969 assigned on September 2023. The practitioner's primary taxonomy code is 363A00000X with license number PA17137 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1568249969
- Provider Name
- JOHAN ERNESTO RIVERA PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3950 N A W GRIMES BLVD STE N201 ROUND ROCK, TX 78665
- Location Phone
- (877) 800-5722
- Mailing Address
- 205 E UNIVERSITY AVE STE 200 GEORGETOWN, TX 78626
- Mailing Phone
- (512) 994-1933
- Medical School Name
- OTHER
- Graduation Year
- 2022
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-11-2023
- Last Update Date
- 10-05-2023
- Code Navigator
A primary care provider (PCP) like Johan Rivera 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
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.
- PA17137
- License State
- TX
- 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:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Clear VALUE Silver - HMO
- Complete VALUE Gold - HMO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Complete VALUE Silver - HMO
- Elite VALUE Bronze - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze VALUE - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple PCP Saver - EPO
- Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible - HMO
- Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs - HMO
- Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs - HMO
- Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs - HMO
- Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs - HMO
- Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist - HMO
- Sendero Health Real Gold / $350 Deductible - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Johan Rivera is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Johan Rivera 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
PECOS PAC ID: 1456707918
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20231019003672
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $17.13 for an established patient copayment.
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 78665 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.
Reviews for JOHAN ERNESTO RIVERA PA
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 6 | 8 | 2 | 4 | 9 | 9 | 6 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 4 | 4 | 18 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 4 + 4 + 1 + 8 + 9 + 1 + 2 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1568249969 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
DR. AMENA DOSSUL M.D
Pediatrics
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
DENISE L PAUTLER M.D.
Pediatrics
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
MS. KATELYN ELIZABETH HECK RN, MSN, CRNP
Nurse Practitioner
(Pediatrics)
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
JENNIFER DAWN DIAZ LPC
Counselor
(Professional)
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
PRIYA CHANDNA RN
Nurse Practitioner
(Pediatrics)
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX
ZIP 78665
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568249969, enumerated as an "individual" on September 11, 2023.
The provider is located at 3950 N A W GRIMES BLVD STE N201 ROUND ROCK, TX 78665 and the phone number is (877) 800-5722.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Superior. Please consult your insurance carrier or call the provider to verify.
