Active NPI
Matthew Marcus Rivera, EMR
- Behavior Technician
- Mesilla, NM
National Provider Identifier
1508396532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2363 Calle del Sur
Mesilla, NM 88463 - Phone
- (575) 527-2566
- NPI assigned
- Jun 13, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 509424993 | NM | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
2363 Calle del Sur
Mesilla, NM 88463
Mailing address
2363 Calle del Sur
Mesilla, NM 88463
Phone (575) 527-2566
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 |
|---|---|---|---|
| 509424993 | NM | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1508396532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2363 CALLE DEL SUR",
"city": "MESILLA",
"state": "NM",
"postal_code": "88463",
"telephone_number": "575-527-2566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2363 CALLE DEL SUR",
"city": "MESILLA",
"state": "NM",
"postal_code": "88463",
"telephone_number": "575-527-2566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MATTHEW",
"middle_name": "MARCUS",
"credential": "EMR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "NM",
"license": "509424993",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesilla, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.