Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johan Ernesto Rivera, PA

Individual provider Physician Assistant · NPI 1568249969

Johan Ernesto Rivera, PA is a Physician Assistant in Round Rock, Texas. Qualified in 2022, 4 years ago. Practices with Seton Family of Doctors, a 785-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3950 N A W Grimes Blvd Ste N201
Round Rock, TX 78665-3540
Phone: (877) 800-5722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA17137 (TX)

Record details

NPI number1568249969
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 11, 2023
Last updated in NPPESOctober 5, 2023
Certification dateOctober 5, 2023
Mailing address205 E University Ave Ste 200, Georgetown, TX 78626-6821

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Seton Family Of Doctors — 785 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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