Oleg Rivkin, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

009405 Issued in NY

Practice address

680 Kinderkamack Rd
Suite 300
Oradell, NJ 07649-1600

Phone

(201) 741-2550

Fax

(201) 342-7171

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1164541165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 300",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-741-2550",
            "fax_number": "201-342-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 300",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-741-2550",
            "fax_number": "201-342-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVKIN",
        "first_name": "OLEG",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Oradell, NJ
• Providers in Oradell, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.