Individual provider Active NPI

Renny Jasmin Rivera

  • Social Worker
  • Bronx, NY
National Provider Identifier
1013574292
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
579 Courtlandt Ave
Bronx, NY 10451-5013
Phone
(718) 485-2100
NPI assigned
May 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

579 Courtlandt Ave
Bronx, NY 10451-5013

Mailing address

2420 Davidson Ave Apt D
Bronx, NY 10468-6350
Phone (347) 213-9240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725001962 NY Practitioner - Clinical Social Worker 5496116303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Jul 12, 2023 Accepting new patients

Locations

579 Courtlandt Ave
Bronx, NY 10451
Phone (718) 908-8000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1013574292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 DAVIDSON AVE APT D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104686350",
            "telephone_number": "347-213-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515013",
            "telephone_number": "718-485-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RENNY",
        "middle_name": "JASMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.