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

Kemisola Lynda Ebietomiye

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1255102976

Kemisola Lynda Ebietomiye is a Nurse Practitioner in New York, New York. Qualified in 2023, 3 years ago. Practices with Rivia Medical PLLC, a 67-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New Jersey, New York and Texas.

Years since qualifying
3
Licensed in
NJ, NY, TX
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

274 Madison Ave Rm 1501
New York, NY 10016-0701
Phone: (212) 203-1773
Fax: (646) 665-4427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2 University Plz Ste 100, Hackensack, NJ 07601-6210 — (212) 203-1773
  • 801 7th Ave, Fort Worth, TX 76104-2733 — (773) 621-8983

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 405625 (NY)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 1149539 (TX)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 26NJ15047800 (NJ)

Record details

NPI number1255102976
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 11, 2024
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Rivia Medical Pllc — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in New York