Riverside Medical Group PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

158051 Issued in NY

Legal business name

RIVERSIDE MEDICAL GROUP PLLC

Practice address

1010 N Broadway
Yonkers, NY 10701-1303

Phone

(914) 968-3535

Fax

(914) 968-3566

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sudhakar Reddy Mettu, M.D.NPI 1366451924

Title

President

Phone

(914) 968-3535

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudhakar Mettu, MD

  • Specialist
  • Yonkers, NY
  • NPI 1366451924
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1265477137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011303",
            "telephone_number": "914-968-3535",
            "fax_number": "914-968-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011303",
            "telephone_number": "914-968-3535",
            "fax_number": "914-968-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "METTU",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-968-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "158051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02544136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yacary Rivera, LMSW
• Yeskeila Rivera
• Rosemarie Yvonne Riveras, FNP
• Riverdale Ophthalmology, PLLC
• Riverhill Podiatry Associates P.C.
• Riverside Pediatrics
• Riverside Sleep Medicine, PLLC
• Riverside Surgical P.C
• Riverside Surgical Services
• Riverview Dental Care

• Primary Care Clinic/Center in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.