Individual provider Active NPI

Carmen Julia Rivera, PH. D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1518021799
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
008453 Issued in NY
Practice address
514 49TH St
Lutheran FHC Sunset Terrace
Brooklyn, NY 11220-2010
Phone
(718) 437-5218
Fax
(718) 437-5239
NPI assigned
Dec 21, 2006
Last updated
Jul 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 008453 NY Primary

Addresses

Primary practice location

514 49TH St
Lutheran FHC Sunset Terrace
Brooklyn, NY 11220-2010

Mailing address

5800 3Rd Ave
Managed Care Department
Brooklyn, NY 11220-3702
Phone (718) 630-7477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20040421001001 NY Practitioner - Clinical Psychologist 6507852019 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

534 48TH St
Brooklyn, NY 11220-1303
Phone (718) 871-2166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Current Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

301 E 17th St
New York, NY 10003
Phone (212) 598-2454

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1518021799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 3RD AVE",
            "address_2": "MANAGED CARE DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203702",
            "telephone_number": "718-630-7477",
            "fax_number": "718-630-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 49TH ST",
            "address_2": "LUTHERAN FHC SUNSET TERRACE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202010",
            "telephone_number": "718-437-5218",
            "fax_number": "718-437-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "CARMEN",
        "middle_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.