Active NPI
Miriandra De Jesus Rivera, M.D.
- Psychiatry Physician
- St Petersburg, FL
National Provider Identifier
1447644836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME137420
- Practice address
- 7901 4TH St N Ste 300
St Petersburg, FL 33702-4399 - Phone
- (813) 591-4938
- Fax
- (813) 219-8035
- NPI assigned
- Mar 24, 2015
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME137420 | FL | Primary |
Addresses
Primary practice location
7901 4TH St N Ste 300
St Petersburg, FL 33702-4399
Mailing address
7901 4TH St N Ste 300
St Petersburg, FL 33702-4399
Phone (813) 591-4938
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | selfimprovementpsych.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME137420 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669075200000",
"number": "1447644836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 4TH ST N STE 300",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337024399",
"telephone_number": "813-591-4938",
"fax_number": "813-219-8035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 4TH ST N STE 300",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337024399",
"telephone_number": "813-591-4938",
"fax_number": "813-219-8035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS RIVERA",
"first_name": "MIRIANDRA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-24",
"last_updated": "2022-11-22",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME137420",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "selfimprovementpsych.com",
"affiliation": "N",
"endpointDescription": "website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7901 4th St N Ste 300",
"city": "St Petersburg",
"state": "FL",
"country_code": "US",
"postal_code": "337024399",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.