Edmundo I Rivera MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME62400 Issued in FL

Legal business name

EDMUNDO I RIVERA MD PA

Practice address

250 Treemont Dr
Orange City, FL 32763-7945

Phone

(386) 774-6001

Fax

(386) 774-6044

NPI assigned

Oct 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Edmundo I Rivera, MDNPI 1437231115

Title

Medical Doctor

Phone

(386) 774-6001

Specialties & licenses 1

Addresses

Other names 1

• West Volusia Psychiatric Associates Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edmundo I Rivera, MD

  • Psychiatry Physician
  • Orange City, FL
  • NPI 1437231115
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1477839306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 TREEMONT DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637945",
            "telephone_number": "386-774-6001",
            "fax_number": "386-774-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 TREEMONT DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637945",
            "telephone_number": "386-774-6001",
            "fax_number": "386-774-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMUNDO I RIVERA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "EDMUNDO",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "386-774-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME62400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Volusia Psychiatric Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dva Healthcare Renal Care Inc
• E&N Loving and Reliable Transportation Services LLC
• Michaelene A Eakin, NP-C
• Erin Elizabeth Ebert, M.S., CCC-SLP
• Lisa M Eddy, LMHC
• Lauren Anne Eggnatz, APRN
• Vahidha Eghbal
• Ahmed Elbanna, D.O.
• Donna L Elbin
• Elder Health Care of Volusia, P.a.

• Psychiatry Physician in Orange City, FL
• Providers in Orange City, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.