Individual provider Active NPI

Ovidiu Dan Rivis, M.D.

  • Psychiatry Physician
  • Augusta, ME
National Provider Identifier
1356359806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
016322 Issued in ME
Practice address
66 Stone St
Augusta, ME 04330-5227
Phone
(207) 626-3455
Fax
(207) 626-3612
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 016322 ME Primary

Addresses

Primary practice location

66 Stone St
Augusta, ME 04330-5227

Mailing address

66 Stone St
Augusta, ME 04330-5227
Phone (207) 626-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627001638 MO Practitioner - Psychiatry 5799688149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
016322MEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Psychiatry CurrentSince Mar 23, 2022 Accepting new patients
State of Missouri Psychiatry CurrentSince Mar 23, 2022 Accepting new patients
State of Missouri Psychiatry Current Accepting new patients
Kennebec Valley Mental Health Center PastSince Nov 6, 2000 Accepting new patients

Locations

3505 Frederick Ave
Saint Joseph, MO 64506
Phone (816) 387-2300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356359806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVIS",
        "first_name": "OVIDIU",
        "middle_name": "DAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "016322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.