Active NPI
Lisa Emilia Rivera
- Behavior Technician
- Pompano Beach, FL
National Provider Identifier
1265794259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1265794259
- Practice address
- 3520 Oaks Way Apt 904
Pompano Beach, FL 33069-5387 - Phone
- (305) 807-1909
- NPI assigned
- Jun 14, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Technician | 106S00000X | 1265794259 | Primary |
Addresses
Primary practice location
3520 Oaks Way Apt 904
Pompano Beach, FL 33069-5387
Mailing address
5617 NW 106TH Way
Coral Springs, FL 33076-3106
Phone (646) 717-2797
Other practice location 1
420 95th Street
William O'Connor School
Brooklyn, NY 11209
Phone (718) 680-9751 ext. 116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265794259 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | http://www.cultivatebhe.com/ | CultivateBHE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1265794259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5617 NW 106TH WAY",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330763106",
"telephone_number": "646-717-2797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3520 OAKS WAY APT 904",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330695387",
"telephone_number": "305-807-1909"
}
],
"practiceLocations": [
{
"address_1": "420 95th Street",
"address_2": "William O'Connor School",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11209",
"country_code": "US",
"telephone_number": "718-680-9751 x116",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIVERA",
"first_name": "LISA",
"middle_name": "EMILIA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-14",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "1265794259",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265794259",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "http://www.cultivatebhe.com/",
"affiliation": "Y",
"affiliationName": "CultivateBHE",
"address_1": "3520 Oaks Way Apt 904",
"city": "Pompano Beach",
"state": "FL",
"country_code": "US",
"postal_code": "330695387",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.