Individual provider Active NPI

Evan Rivera, NP

  • Adult Health Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1356170971
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311851 Issued in NY
Practice address
181 N Belle Mead Rd Ste 6
East Setauket, NY 11733-3495
Phone
(631) 444-2599
NPI assigned
Jul 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311851 NY Primary

Addresses

Primary practice location

181 N Belle Mead Rd Ste 6
East Setauket, NY 11733-3495

Mailing address

8 Pine Cone CT
Wading River, NY 11792-2155
Phone (631) 875-2453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001001644 NY Practitioner - Nurse Practitioner 0446781595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2599

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo CurrentSince Oct 1, 2024 Accepting new patients

Locations

500 Commack Rd
Ste 201
Commack, NY 11725
Phone (631) 638-0597

181 N Belle Mead Rd
Ste 6
East Setauket, NY 11733
Phone (516) 324-7500

4 Smith Haven Mall
Ste 105
Lake Grove, NY 11755

100 Nicolls Rd
Rm 60
Stony Brook, NY 11794
Phone (631) 444-7653

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1356170971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PINE CONE CT",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922155",
            "telephone_number": "631-875-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD STE 6",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EVAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.