Active NPI
Kimberly Mabel Rivera
- Social Worker
- Bronx, NY
National Provider Identifier
1477033991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 090754
- Practice address
- 2940 Grand Concourse Apt 1B
Bronx, NY 10458-2612 - Phone
- (347) 577-5844
- NPI assigned
- Aug 14, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 090754 | NY | Primary |
Addresses
Primary practice location
2940 Grand Concourse Apt 1B
Bronx, NY 10458-2612
Mailing address
3121 Villa Ave Apt 3B
Bronx, NY 10468-1374
Phone (347) 725-5248
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
| License | State | Type | Specialty |
|---|---|---|---|
| 090754 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1477033991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3121 VILLA AVE APT 3B",
"city": "BRONX",
"state": "NY",
"postal_code": "104681374",
"telephone_number": "347-725-5248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 GRAND CONCOURSE APT 1B",
"city": "BRONX",
"state": "NY",
"postal_code": "104582612",
"telephone_number": "347-577-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "KIMBERLY",
"middle_name": "MABEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-14",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "090754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.