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Deactivated NPI 1124895321 Deactivated / Inactive NPI Female Practitioner

Rose Lee Rivera

Licensed Practical Nurse • Perth Amboy, 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, Rose Rivera has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 07, 2023
NPI Deactivation Date April 03, 2025
Total Practice Duration ~2 Years of Practice (2023 – 2025)

Professional Overview & Biography Verified Profile Summary

Rose Rivera was a registered Licensed Practical Nurse practicing in Perth Amboy, NJ. Throughout an active medical career spanning 2 years, Rose Rivera provided care at the practice location at 282 HERBERT ST until profile deactivation on 2025-04-03.

Practice Location & Contact Primary Location

Practice Address

282 Herbert St

Perth Amboy, NJ 088613706

Telephone 9083421438
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1164437059

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Perth Amboy, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Perth Amboy, NJ (1119 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NJ 26NP49513900

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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 April 03, 2025

Record deactivated on April 03, 2025

NPI Profile Active December 07, 2023

NPI status registered as active in NPPES database

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Updated Practice Location December 07, 2023

Registered at 282 HERBERT ST, PERTH AMBOY, NJ 088613706 (Tel: 9083421438)

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Updated Business Mailing Address December 07, 2023

Registered at 401 RAHWAY AVE, ELIZABETH, NJ 072022307 (Tel: 9084579203)

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Provider Name / Credentials Updated December 07, 2023

Recorded as ROSE RIVERA

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2023

Licensed Practical Nurse (License #26NP49513900 in NJ)

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Initial NPI Registration & Enumeration December 07, 2023

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: 1124895321
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 07, 2023
Last Update: December 07, 2023
Deactivation Date: April 03, 2025

Mailing Address

401 Rahway Ave

Elizabeth, NJ 072022307

Phone: 9084579203

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.