Active NPI
Edward Philip Rivera, M.D.
- Psychiatry Physician
- Gardner, MA
National Provider Identifier
1184710535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 215864
- Practice address
- 242 Green St
Gardner, MA 01440-1336 - Phone
- (617) 818-3123
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 215864 | MA | Primary |
Addresses
Primary practice location
242 Green St
Gardner, MA 01440-1336
Mailing address
242 Green St
Gardner, MA 01440-1336
Phone (617) 818-3123
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215864 | MA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heywood Medical Group Inc. | Family Medicine | Past | 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": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197504000000",
"number": "1184710535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401336",
"telephone_number": "617-818-3123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401336",
"telephone_number": "617-818-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "EDWARD",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "215864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.