Individual provider Active NPI

Doreen Riser, A.P., L.AC

  • Acupuncturist
  • Indian Harbour Beach, FL
National Provider Identifier
1417100496
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
3856 Issued in FL
Practice address
1875 S Patrick Dr
Indian Harbour Beach, FL 32937-4386
Phone
(973) 879-6601
NPI assigned
Nov 4, 2008
Last updated
Dec 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 003438 NY
Acupuncturist 171100000X 3856 FL Primary

Addresses

Primary practice location

1875 S Patrick Dr
Indian Harbour Beach, FL 32937-4386

Mailing address

4007 N Harbor City Blvd Apt 105
Melbourne, FL 32935-5765
Phone (973) 879-6601

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

LicenseStateTypeSpecialty
3856FLMDOptometrist
003438NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Acupuncture LLC Acupuncturist CurrentSince Jan 21, 2024 Accepting new patients

Locations

1360 South Patrick Dr
Ste 10
Satellite Beach, FL 32937
Phone (321) 294-7416

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, 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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1417100496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 N HARBOR CITY BLVD APT 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355765",
            "telephone_number": "973-879-6601",
            "fax_number": "914-617-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 S PATRICK DR",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374386",
            "telephone_number": "973-879-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISER",
        "first_name": "DOREEN",
        "name_prefix": "Ms.",
        "credential": "A.P., L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003438",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "3856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.