Active NPI
Jessica Rivera
- Optician
- Middletown, CT
National Provider Identifier
1063750396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 001672
- Practice address
- 438 Main St
Suite 204
Middletown, CT 06457-3396 - Phone
- (888) 964-6681
- Fax
- (888) 662-0859
- NPI assigned
- Jan 22, 2013
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 001672 | CT | Primary |
Addresses
Primary practice location
438 Main St
Suite 204
Middletown, CT 06457-3396
Mailing address
888 Worcester St
Suite 130
Wellesley, MA 02482-3744
Phone (617) 964-6681
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 |
|---|---|---|---|
| 001672 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1063750396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "888 WORCESTER ST",
"address_2": "SUITE 130",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024823744",
"telephone_number": "617-964-6681",
"fax_number": "339-686-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 MAIN ST",
"address_2": "SUITE 204",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573396",
"telephone_number": "888-964-6681",
"fax_number": "888-662-0859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-22",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CT",
"license": "001672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.