Juan P Richiusa, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

236310 Issued in MA

Practice address

680 Centre St
Brockton, MA 02302-3308

Phone

(508) 941-7379

Fax

(508) 941-6330

NPI assigned

Aug 10, 2007

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA, FL2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Ponce School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers of Southwest Florida IncGroup PAC ID 3173432085, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juan.richiusa@direct.signature.masshiway.net

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.

• Family Health Centers of Southwest Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1326090390
  Medicare reassignment Care Compare group
• Obhg Massachusetts - Direct, P.C.

  • Obstetrics Physician
  • Brockton, MA
  • NPI 1487229035
  Medicare reassignment NPD
• Signature Healthcare Medical Group Inc

  dba Signature Medical

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Family Health Centers of Southwest Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1669634903
  NPD
• Women's Health Affiliates, Inc.

  dba Signature Healthcare Women's Health Affiliates

  • Obstetrics & Gynecology Physician
  • Brockton, MA
  • NPI 1396783742
  NPD (past)
• Family Health Centers of Southwest Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1891010393
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1164614434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919771",
            "telephone_number": "239-278-3600",
            "fax_number": "239-226-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7379",
            "fax_number": "508-941-6330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Summer Ridge Lane",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339084064",
            "country_code": "US",
            "telephone_number": "239-344-2348",
            "fax_number": "239-479-5194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHIUSA",
        "first_name": "JUAN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME114613",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "236310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008606100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall L Richard, MA, MTH, MFA
• Tracey Joy Richard, LMHC
• Heidi Richards, MS (MFT)
• Donovan Richardson
• Marcia J Richardson, LICSW, ACSW
• John Rider
• Kelly R Ridge, PAC
• Rightcare at Home LLC
• Kimberly Anne Riker
• Elizabeth Mary Riley

• Obstetrics & Gynecology Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.