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Deactivated NPI 1104909134 Deactivated / Inactive NPI Female Practitioner

Adele Grace Rivas , PA-C

Physician Assistant - Medical • Fair Lawn, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Adele Rivas has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 23, 2006
NPI Deactivation Date June 21, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Adele Rivas, PA-C was a registered Physician Assistant - Medical practicing in Fair Lawn, NJ. Throughout an active medical career spanning 13 years, Adele Rivas provided care at the practice location at 22-18 BROADWAY until profile deactivation on 2019-06-21.

Historical Medicare Part B clinical services included emergency department visit with moderate level of medical decision making, emergency department visit for life threatening or functioning severity. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

22-18 Broadway

Fair Lawn, NJ 074103016

Telephone 2014755050
Fax 2014755522
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Medical in Fair Lawn, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.0 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
5 Specialists

Practicing in Fair Lawn, NJ (802 Statewide)

Telehealth Adoption Rate
20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
87.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99284 Emergency department visit with moderate level of medical decision making
23 23 $861.00 $106.20
99285 Emergency department visit for life threatening or functioning severity
20 19 $1284.00 $155.98

Medical Specialties & State Licenses

Physician Assistant - Medical Primary Specialty

NUCC Taxonomy Code: 363AM0700X

State License NJ 25MP00102400

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

20 Associated Practitioners
Meredith Lubas , NP

Nurse Practitioner - Primary Care

NPI 1063996650

Nurse Practitioner

Dr. Rimvida Obeleniene , MD FACC

Internal Medicine - Cardiovascular Disease

NPI 1073559597

MDFACC

Catherine Carlton , APN

Nurse Practitioner - Adult Health

NPI 1104170851

Advanced Practice Nurse

Dr. Mahesh Bikkina , MD FACC FSCAI

Internal Medicine - Cardiovascular Disease

NPI 1205856002

MDFACCFSCAI

Dr. David Chabbott , MD

Internal Medicine - Cardiovascular Disease

NPI 1326330606

Doctor of Medicine (M.D.)

Dr. Kiran Syed , MD

Family Medicine

NPI 1396207056

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 21, 2019

Record deactivated on June 21, 2019

NPI Profile Active March 20, 2013

NPI status registered as active in NPPES database

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Updated Practice Location March 20, 2013

Registered at 22-18 BROADWAY, FAIR LAWN, NJ 074103016 (Tel: 2014755050)

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Updated Business Mailing Address March 20, 2013

Registered at 22-18 BROADWAY, FAIR LAWN, NJ 074103016 (Tel: 2014755050)

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Provider Name / Credentials Updated March 20, 2013

Recorded as ADELE RIVAS, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 20, 2013

Physician Assistant (License #25MP00102400 in NJ)

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Initial NPI Registration & Enumeration October 23, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104909134
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 23, 2006
Last Update: March 20, 2013
Deactivation Date: June 21, 2019

Mailing Address

22-18 Broadway

Fair Lawn, NJ 074103016

Phone: 2014755050

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.