Active NPI
Maria J Rivera, OD
- Optometrist
- Tulsa, OK
National Provider Identifier
1023625167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3096
- Practice address
- 602 S Utica Ave
Tulsa, OK 74104-2641 - Phone
- (918) 585-3744
- Fax
- (918) 535-3774
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3096 | OK | Primary |
Addresses
Primary practice location
602 S Utica Ave
Tulsa, OK 74104-2641
Mailing address
2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3096 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1023625167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 E BIJOU ST STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809098009",
"telephone_number": "719-576-1850",
"fax_number": "719-955-3470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 S UTICA AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741042641",
"telephone_number": "918-585-3744",
"fax_number": "918-535-3774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MARIA",
"middle_name": "J",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "3096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.