Active NPI
Jose Manuel Gonzalez Rivera, PHARM.D.
- Pharmacist
- Sunnyside, NY
National Provider Identifier
1235721804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067505
- Practice address
- 4315 46TH St Apt F10
Sunnyside, NY 11104-2015 - Phone
- (939) 275-1781
- NPI assigned
- Feb 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 067505 | NY | Primary |
Addresses
Primary practice location
4315 46TH St Apt F10
Sunnyside, NY 11104-2015
Mailing address
4315 46TH St Apt F10
Sunnyside, NY 11104-2015
Phone (939) 275-1781
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000 | Medicaid | NY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sunnyside | Health Information Exchange (HIE) | |
| CONNECT URL | sunnyside | Direct |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 067505 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1235721804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4315 46TH ST APT F10",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111042015",
"telephone_number": "939-275-1781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4315 46TH ST APT F10",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111042015",
"telephone_number": "939-275-1781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ RIVERA",
"first_name": "JOSE",
"middle_name": "MANUEL",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-05",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NY",
"license": "067505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sunnyside",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"contentOtherDescription": "sunnyside",
"address_1": "4315 46th St Apt F10",
"city": "Sunnyside",
"state": "NY",
"country_code": "US",
"postal_code": "111042015",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sunnyside",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4315 46th St Apt F10",
"city": "Sunnyside",
"state": "NY",
"country_code": "US",
"postal_code": "111042015",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sunnyside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.