Active NPI
Kathleen L Rivero
- Clinical Psychologist
- Wauwatosa, WI
National Provider Identifier
1104357904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3412-057
- Practice address
- 1220 Dewey Ave
Wauwatosa, WI 53213-2504 - Phone
- (414) 454-6600
- NPI assigned
- Mar 23, 2017
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3412-057 | WI | Primary |
Addresses
Primary practice location
1220 Dewey Ave
Wauwatosa, WI 53213-2504
Mailing address
1220 Dewey Ave
Wauwatosa, WI 53213-2504
Phone (414) 454-6600
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krivero187671@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3412-057 | WI | MD | Clinical Psychologist |
Interoperability endpoints
- krivero187671@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1104357904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 DEWEY AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132504",
"telephone_number": "414-454-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 DEWEY AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132504",
"telephone_number": "414-454-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERO",
"first_name": "KATHLEEN",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "3412-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krivero187671@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1220 Dewey Ave",
"city": "Wauwatosa",
"state": "WI",
"country_code": "US",
"postal_code": "532132504",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1220 Dewey Ave",
"city": "Wauwatosa",
"state": "WI",
"country_code": "US",
"postal_code": "532132504",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.