Active NPI
Carmelo Rivera Jr., R.D.
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1205123593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 006442-1
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (718) 518-5026
- NPI assigned
- Jul 7, 2011
- Last updated
- Jul 7, 2011
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 006442-1 | NY | Primary |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
1226 Sherman Ave
Apt 21
Bronx, NY 10456-3015
Phone (646) 641-7427
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006442-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aramark | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Bronx, NY
- NPI 1003125691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309996800000",
"number": "1205123593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1226 SHERMAN AVE",
"address_2": "APT 21",
"city": "BRONX",
"state": "NY",
"postal_code": "104563015",
"telephone_number": "646-641-7427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-518-5026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "CARMELO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2011-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "006442-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.