Active NPI
Nadia Lia Rivera-Dejesus
- Specialist
- Ridgewood, NY
National Provider Identifier
1215334255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 694583
- Practice address
- 1823 Madison St
10
Ridgewood, NY 11385-3750 - Phone
- (646) 287-4706
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 694583 | NY | Primary |
Addresses
Primary practice location
1823 Madison St
10
Ridgewood, NY 11385-3750
Mailing address
1823 Madison St
10
Ridgewood, NY 11385-3750
Phone (646) 287-4706
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
| License | State | Type | Specialty |
|---|---|---|---|
| 694583 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| N L Rivera-de Jesus, Msed, Inc. | 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.
-
- Behavior Analyst
- Ridgewood, NY
- NPI 1356881320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1215334255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1823 MADISON ST",
"address_2": "10",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853750",
"telephone_number": "646-287-4706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1823 MADISON ST",
"address_2": "10",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853750",
"telephone_number": "646-287-4706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA-DEJESUS",
"first_name": "NADIA",
"middle_name": "LIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "694583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.