Individual provider Active NPI

Erin Rivelis, PH.D.

  • Psychologist
  • Bronx, NY
National Provider Identifier
1437439288
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018365 Issued in NY
Practice address
1225 Morris Park Ave
Bronx, NY 10461-1949
Phone
(718) 839-7044
NPI assigned
Aug 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018365 NY Primary

Addresses

Primary practice location

1225 Morris Park Ave
Bronx, NY 10461-1949

Mailing address

70 Berry St Apt 4D
Brooklyn, NY 11249-1816
Phone (917) 921-8331

Other practice location 1

15 E 10th St Apt 1A
New York, NY 10003-5931
Phone (347) 530-4082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160826001894 NY Practitioner - Clinical Psychologist 1850686049 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018365NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 22, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Jun 22, 2016 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1225 Morris Park Ave
Bronx, NY 10461
Phone (718) 430-8500

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1437439288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BERRY ST APT 4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112491816",
            "telephone_number": "917-921-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611949",
            "telephone_number": "718-839-7044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 E 10th St Apt 1A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100035931",
            "country_code": "US",
            "telephone_number": "347-530-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVELIS",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.