NPIMap

Organization Active NPI

Dr. Mariola Rivera Podiatry, PLLC

  • Foot Surgery Podiatrist
  • White Plains, NY
National Provider Identifier
1396233664
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
006721 Issued in NY
Legal business name
DR. MARIOLA RIVERA PODIATRY, PLLC
Practice address
10 Mitchell PL Ste 105
White Plains, NY 10601-4300
Phone
(914) 328-3400
Fax
(914) 290-5795
NPI assigned
Apr 23, 2018
Last updated
Apr 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Dr. Mariola Rivera Morell, DPMNPI 1093111866
Title
President
Phone
(914) 325-7414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 006721 NY Primary

Addresses

Primary practice location

10 Mitchell PL Ste 105
White Plains, NY 10601-4300

Mailing address

15 Winkler Farm Rd
Bedford, NY 10506-1733
Phone (914) 325-7414

Other identifiers 1

IdentifierTypeStateIssuer
1093111866OtherNYINDIVIDUAL

Other names 1

  • Dr. Mariola Rivera Podiatry, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180612000207 NY Part B Supplier - Clinic/Group Practice 4284989476 Receives reassigned benefits from 3 practitioners
Practice locations: Purchase, NY; White Plains, NY
O20190718000772 NY DME Supplier - Physician - Podiatry 4284989476 Practice locations: White Plains, NY

National Provider Directory

National Provider Directory

Locations

3010 Westchester Ave
Ste 208
Purchase, NY 10577
Phone (914) 939-4101

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1396233664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WINKLER FARM RD",
            "city": "BEDFORD",
            "state": "NY",
            "postal_code": "105061733",
            "telephone_number": "914-325-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MITCHELL PL STE 105",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014300",
            "telephone_number": "914-328-3400",
            "fax_number": "914-290-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARIOLA RIVERA PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "RIVERA MORELL",
        "authorized_official_first_name": "MARIOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-325-7414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "006721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1093111866",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Mariola Rivera Podiatry, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.