Individual provider Active NPI

Akeisha La Toya Rivera, PSY.D.

  • Clinical Psychologist
  • Rye Brook, NY
National Provider Identifier
1174810147
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020809 Issued in NY
Practice address
800 Westchester Ave Ste N641
Rye Brook, NY 10573
Phone
(914) 231-0362
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 020809 NY Primary

Addresses

Primary practice location

800 Westchester Ave Ste N641
Rye Brook, NY 10573

Mailing address

34 Ramona Rd
Newburgh, NY 12550-7010
Phone (720) 425-1321

Other names 1

  • Ms. Akeisha La Toya Mitchell Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004002207 NY Practitioner - Clinical Psychologist 6204124464 Practice locations: Rye Brook, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Westchester Ave
Suite N641
Rye Brook, NY 10573-1360
Phone (914) 290-4441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020809NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy Keller, LCSW, LLC PastSince Oct 1, 2011 Accepting new patients

Organizations & group practices 1

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1174810147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RAMONA RD",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125507010",
            "telephone_number": "720-425-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE STE N641",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "10573",
            "telephone_number": "914-231-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "AKEISHA",
        "middle_name": "LA TOYA",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AKEISHA",
            "last_name": "MITCHELL",
            "middle_name": "LA TOYA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rye Brook, NY

Sources for this page

Verify at the official NPI Registry.