Individual provider Active NPI

Nicole Vanessa Rivera, MD

  • Psychiatry Physician
  • Providence, RI
National Provider Identifier
1356874085
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD17521 Issued in RI
Practice address
345 Blackstone BLV
Psychiatry
Providence, RI 02906-0290
Phone
(401) 455-6200
Fax
(401) 455-6689
NPI assigned
Apr 10, 2017
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 MD17521 RI Primary

Addresses

Primary practice location

345 Blackstone BLV
Psychiatry
Providence, RI 02906-0290

Mailing address

3600 Forbes Ave
Forbes Tower Plaza Suite 140
Pittsburgh, PA 15213-3410

Other practice location 1

3600 Forbes Ave
Forbes Tower Plaza Suite 140
Pittsburgh, PA 15213-3410
Phone (412) 647-6340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nrivera@kent.cernerdirect.carene.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20210607002386 RI Practitioner - PsychiatryPractitioner - Neurology 2365711421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Aug 1, 2021 Accepting new patients
Butler Hospital Current Accepting new patients
Affinity Physicians LLC. Neurology CurrentSince Aug 1, 2021 Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/713ac9f5-15a6-4520-831d-8a5ba81c49d0/

Organizations & group practices 3

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1356874085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE",
            "address_2": "FORBES TOWER PLAZA SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLV",
            "address_2": "PSYCHIATRY",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029060290",
            "telephone_number": "401-455-6200",
            "fax_number": "401-455-6689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Forbes Ave",
            "address_2": "Forbes Tower Plaza Suite 140",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152133410",
            "country_code": "US",
            "telephone_number": "412-647-6340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NICOLE",
        "middle_name": "VANESSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD17521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrivera@kent.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blv",
            "address_2": "Psychiatry",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029060290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.