Organization Active NPI

Jose Gomez-Rivera, M.D., P.C.

  • Psychiatry Physician
  • Newark, NJ
National Provider Identifier
1114051125
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JOSE GOMEZ-RIVERA, M.D., P.C.
Practice address
221 Summer Ave
Newark, NJ 07104-2626
Phone
(973) 482-9106
Fax
(973) 482-5895
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jose Gomez-Rivera, MD
Title
President
Phone
(973) 482-9106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X NJ Primary

Addresses

Primary practice location

221 Summer Ave
Newark, NJ 07104-2626

Mailing address

66 W Gilbert St
2ND Floor
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
1295608MedicaidNJ

National Provider Directory

National Provider Directory

Locations

221 Summer Ave
Newark, NJ 07104
Phone (973) 218-1868

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114051125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FLOOR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SUMMER AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071042626",
            "telephone_number": "973-482-9106",
            "fax_number": "973-482-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE GOMEZ-RIVERA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOMEZ-RIVERA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-482-9106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295608",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.