Individual provider Active NPI

Sandra Rivera

  • Social Worker
  • Jamaica, NY
National Provider Identifier
1174065957
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
001209 Issued in CT
Practice address
176-20 148TH Avenue
Jamaica, NY 11143
Phone
(347) 418-5176
NPI assigned
Nov 10, 2016
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 001209 CT Primary

Addresses

Primary practice location

176-20 148TH Avenue
Jamaica, NY 11143

Mailing address

1667 Rockaway Pkwy
Brooklyn, NY 11236-4317
Phone (347) 418-5176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001209CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1174065957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364317",
            "telephone_number": "347-418-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176-20 148TH AVENUE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11143",
            "telephone_number": "347-418-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "001209",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 10, 2016; 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.