Active NPI
Carmina Ramona Nolasco Rivera, M.D.
- Pediatrics Physician
- Jamaica, NY
National Provider Identifier
1124277793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 250151
- Practice address
- 18730 Hillside Ave
Jamaica, NY 11432-3216 - Phone
- (718) 264-1111
- NPI assigned
- Sep 18, 2008
- Last updated
- Dec 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 250151 | NY | Primary |
Addresses
Primary practice location
18730 Hillside Ave
Jamaica, NY 11432-3216
Mailing address
183 109TH Ave
Elmont, NY 11003-2017
Phone (516) 502-6574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03038002 | Medicaid | NY |
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: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillside Polymedic Diagnostic & Treatment Center Inc | Current | Accepting new patients | |
| Hillside Polymedic P.C. | Pediatrics | Past | Accepting new patients |
Locations
18730 Hillside Ave
Jamaica, NY 11432
Phone (718) 264-1111
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- carminar@hillsidepolymedic.medentdirect.com
Organizations & group practices 2
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.
-
- Clinic/Center
- Jamaica, NY
- NPI 1689879280
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1124277793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183 109TH AVE",
"city": "ELMONT",
"state": "NY",
"postal_code": "110032017",
"telephone_number": "516-502-6574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18730 HILLSIDE AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114323216",
"telephone_number": "718-264-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "CARMINA RAMONA",
"middle_name": "NOLASCO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-18",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "250151",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03038002",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.