KELLY ANN RIVERA (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1134900012

KELLY ANN RIVERA (PMHNP) is a healthcare provider. based in Worcester, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. RN205716 (MA). The NPI Number for KELLY ANN RIVERA (PMHNP) is 1134900012

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANN RIVERA (PMHNP)
NPI
1134900012
Phone
(508) 753-5554
Address
435 SHREWSBURY ST
Enumeration Date
9 October 2023
Last Update Date
9 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5087535554110
Graduation Year
2023 (3 years ago)
PAC ID
9335599828
Group Practice PAC ID
3779818828
Professional Enrollment ID
I20231226000508
Address ID
MA016041689WO435XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,049 NURSE PRACTITIONER in MA

Provider Addresses for KELLY ANN RIVERA (PMHNP)

  • 435 SHREWSBURY ST

    WORCESTER, MA 016041689

    Phone: (508) 753-5554

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 104 Open Payments records for all available years, with a total value of $2,205.

Total Amount is formed as General ($2,205) + Research ($0) + Ownership ($0) = $2,205.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($491).

Total Amount

$2,205

General + Research + Ownership

Payments

104

Total payment records

General Amount

$2,205

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-26

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231226000508INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779818828View full group profile
NameSpecialtyState
Nurse PractitionerMA
Nurse PractitionerMA
Mental Health CounselorMA
Clinical PsychologistMA
P S Y C H I A T R YMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Mental Health CounselorMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What NPI should I save for KELLY ANN RIVERA (PMHNP)?
Save NPI 1134900012 if you need a stable reference for KELLY ANN RIVERA (PMHNP).
Does this profile mean KELLY ANN RIVERA (PMHNP) is currently active?
Yes — KELLY ANN RIVERA (PMHNP) appears active in the national provider directory.
What kind of provider is KELLY ANN RIVERA (PMHNP)?
The page reflects Psychiatric/Mental Health Nurse Practitioner for KELLY ANN RIVERA (PMHNP). Clinical services aligned with this taxonomy classification.
Where is KELLY ANN RIVERA (PMHNP)'s primary listing?
We display Worcester, Massachusetts because that is what the record indicates for KELLY ANN RIVERA (PMHNP).
How can I contact KELLY ANN RIVERA (PMHNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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