Richard Primavera, DPM CWS FACFAOM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

MD01214 Issued in NJ

Practice address

179 Norwood Ave
Long Branch, NJ 07740-5403

Phone

(732) 222-3917

Fax

(732) 222-0324

NPI assigned

Aug 2, 2005

Last updated

Jan 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Podiatry

Education

Temple University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Associated Podiatry Group of Long Branch, PA

  • Foot Surgery Podiatrist
  • Oakhurst, NJ
  • NPI 1699936146
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1104827914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 REDWOOD DR",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077128702",
            "telephone_number": "732-610-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 NORWOOD AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405403",
            "telephone_number": "732-222-3917",
            "fax_number": "732-222-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMAVERA",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPM CWS FACFAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD01214",
            "primary": true
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "NJ",
            "license": "MD01214",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "MD01214",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "NJ",
            "license": "MD01214",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NJ",
            "license": "MD01214",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "MD01214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niharika Podaralla, MD
• Jessica Rose Pogran, D.O.
• Paul John Poliviou, OTR/L
• Shatiera Myesha Portee, LAC,NCC
• Possibilities Plus, LLC
• Alissa Principato, APN
• Hannah Proodian, OTR
• James Proodian, D.C.
• Propel Rehabilitation & Wellness LLC
• PT on the Go PC

• Podiatrist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.