Individual provider Active NPI

Alexa Rivera, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1154957058
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
317 E 17TH St
New York, NY 10003-3804
Phone
(212) 420-2390
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

317 E 17TH St
New York, NY 10003-3804

Mailing address

317 E 17TH St
New York, NY 10003-3804

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227003780 NY Practitioner - Psychiatry 6901387893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Florida State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Realization Center IncGroup PAC ID 0749598050, 11 clinicians

Practice addresses (Care Compare)

19 Union SQ W
FL 7
New York, NY 10003-3304
Phone (212) 627-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Realization Center, Inc. Single Specialty CurrentSince Feb 1, 2026 Accepting new patients
Realization Center PastSince Feb 1, 2026 Accepting new patients

Locations

19 Union Sq W
Fl 7
New York, NY 10003
Phone (212) 627-9600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1154957058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-420-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ALEXA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.