Lucas Riabowol

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02758600 Issued in NJ

Practice address

1 Howell Rd
Bridgewater, NJ 08807-3800

Phone

(908) 642-5125

NPI assigned

Jun 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Star Community Health, Inc

  • General Practice Physician
  • Bethlehem, PA
  • NPI 1033686159
  Medicare reassignment NPD
• Star Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Bethlehem, PA
  • NPI 1942832720
  NPD

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560643200000",
    "number": "1295395960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOWELL RD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073800",
            "telephone_number": "908-642-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOWELL RD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073800",
            "telephone_number": "908-642-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIABOWOL",
        "first_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-16",
        "last_updated": "2019-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02758600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Reyes
• Julia Alejandra Reyes
• Erin Reyhan
• Andrea Isabelle Reznik, MD
• Gabrielle Rhyner, MS, NCC, LPC, SAC
• Kyle Riccelli
• Susan J Rice, OD
• Richard Hall Community Mental Health Center
• Richard Hall Community Mental Health Center
• Paulie Simon Richard

• Dentist in Bridgewater, NJ
• Providers in Bridgewater, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.