Emmanuel Rivera

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

80863 Issued in TX

Practice address

2211 S Interstate 35 Ste 103
Austin, TX 78741-3842

Phone

(512) 766-3627

NPI assigned

Jun 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gramercy Specialty Clinic PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1922419324
  Medicare reassignment NPD
• Gramercy Specialty Clinic

  • Professional Counselor
  • Austin, TX
  • NPI 1780051623
  NPD (past)

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1467020222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S INTERSTATE 35 STE 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413842",
            "telephone_number": "512-766-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S INTERSTATE 35 STE 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413842",
            "telephone_number": "512-766-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EMMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audelio Rivera Jr.
• Coleen Dorothy Obsioma Rivera
• Debbie Lee Ann Rivera, DC
• Diana Rivera, PT, DPT
• Emily Rivera, APRN, WHNP-BC
• Gabriela Rivera
• Genesis Rivera
• Ismael Omar Rivera, M.D.
• Marissa Rivera
• Marissa Kathleen Rivera

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.