Individual provider Active NPI

Mary L Rivera-Casamento, MD

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1205225430
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
184651 Issued in NY
Practice address
936 5TH Ave
New York, NY 10021-2653
Phone
(212) 734-1893
Fax
(212) 734-0431
NPI assigned
Jan 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 184651 NY Primary

Addresses

Primary practice location

936 5TH Ave
New York, NY 10021-2653

Mailing address

936 5TH Ave
New York, NY 10021-2653
Phone (212) 734-1893

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401001701 NY Practitioner - Obstetrics/Gynecology 2365434941 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
184651NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince Oct 14, 2019 Accepting new patients
Lenox Hill Hospital Past Accepting new patients
Weill Medical College of Cornell Obstetrics & Gynecology Past Accepting new patients

Locations

260 E 67th St
Ste B
New York, NY 10065
Phone (212) 629-2000

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: mriveracasamento67367@northwell.direct-ci.com

Organizations & group practices 4

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": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1205225430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212653",
            "telephone_number": "212-734-1893",
            "fax_number": "212-734-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212653",
            "telephone_number": "212-734-1893",
            "fax_number": "212-734-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-CASAMENTO",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "184651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.