Individual provider Active NPI

Silena Rivera, OD

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1053827543
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008712-1 Issued in NY
Practice address
2748 Hylan Blvd
Staten Island, NY 10306
Phone
(718) 979-2200
NPI assigned
Dec 19, 2017
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008712-1 NY Primary

Addresses

Primary practice location

2748 Hylan Blvd
Staten Island, NY 10306

Mailing address

2748 Hylan Blvd
Staten Island, NY 10306-4658
Phone (718) 979-2200

Other practice location 1

2303 Richmond Ave
Staten Island, NY 10314-3918
Phone (718) 982-9602

Other practice location 2

16413 Jamaica Ave
Jamaica, NY 11432-4913
Phone (929) 218-7155

Other practice location 3

2748 Hylan Blvd
Staten Island, NY 10306
Phone (718) 979-2200

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180209001649 NY Practitioner - Optometry 7012277197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2748 Hylan Blvd
Staten Island, NY 10306-4658
Phone (718) 979-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008712-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Optical Corp Optometrist CurrentSince Dec 12, 2017 Accepting new patients
Beautiful Eyes Optical Corp Optometrist CurrentSince Dec 12, 2018 Accepting new patients
General Vision Services LLC PastSince Dec 12, 2018 Accepting new patients

Locations

12102 Liberty Ave
South Richmond Hill, NY 11419
Phone (718) 641-1160

2748 Hylan Blvd
Staten Island, NY 10306
Phone (718) 979-2200

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1053827543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064658",
            "telephone_number": "718-979-2200",
            "fax_number": "718-979-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-979-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2303 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103143918",
            "country_code": "US",
            "telephone_number": "718-982-9602",
            "fax_number": "718-982-9607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16413 Jamaica Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114324913",
            "country_code": "US",
            "telephone_number": "929-218-7155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2748 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10306",
            "country_code": "US",
            "telephone_number": "718-979-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SILENA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008712-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.