Active NPI
Karen Rivera, PTA
- Physical Therapy Assistant
- Port Jefferson, NY
National Provider Identifier
1386067791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 66008346
- Practice address
- 75 N Country Rd
Port Jefferson, NY 11777-2119 - Phone
- (631) 476-2737
- NPI assigned
- Jan 22, 2014
- Last updated
- Jan 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 66008346 | NY | Primary |
Addresses
Primary practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Mailing address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 476-2737
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66008346 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1386067791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-476-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-476-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "KAREN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-22",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "66008346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
- Amy Renee Richter, MD
- Gabrielle Liane Richter
- Meredith R Rickenbacker, LCSW
- Zachary C Riggio, DPT
- Samantha Riley, PA-C
- Robert M Woznicki MD PC
- Robert Wilutis Occupational and Physical Therapy PLLC (Robert Wilutis Hand Therapy PLLC)
- Robert Wilutis Occupational and Physical Therapy, PLLC (Robert Wilutis Hand Therapy, PLLC)
- Eric L Roberts, M.D.
- Daisy Denise Rodriguez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.