Individual provider Active NPI

Richard Rivera, L.M.S.W.

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1023237799
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079191 Issued in NY
Practice address
14 Slosson Ter
Staten Island, NY 10301-2507
Phone
(718) 720-6727
Fax
(718) 720-0326
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072151-1 NY
Clinical Social Worker 1041C0700X 079191 NY Primary

Addresses

Primary practice location

14 Slosson Ter
Staten Island, NY 10301-2507

Mailing address

70 Washington St
Apt 3C
Brooklyn, NY 11201-1443
Phone (914) 543-1011

Other practice location 1

70 Washington St
Apt 3C
Brooklyn, NY 11201-1443
Phone (914) 543-1011

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
I20181107001666 NY Practitioner - Clinical Social Worker 4082968243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Canino LCSW Psychotherapy, PCGroup PAC ID 2961589577, 15 clinicians

Practice addresses (Care Compare)

70 Washington St
Apt 3C
Brooklyn, NY 11201-1443
Phone (718) 983-8872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072151-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Canino LCSW Psychotherapy PC CurrentSince Aug 19, 2018 Accepting new patients

Locations

1082 Victory Blvd
Staten Island, NY 10301
Phone (718) 815-3500

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1023237799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "APT 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011443",
            "telephone_number": "914-543-1011",
            "fax_number": "718-852-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-720-6727",
            "fax_number": "718-720-0326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 WASHINGTON ST",
            "address_2": "APT 3C",
            "address_purpose": "LOCATION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011443",
            "country_code": "US",
            "telephone_number": "914-543-1011",
            "fax_number": "718-852-6921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RICHARD",
        "credential": "L.M.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072151-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.