Individual provider Active NPI

Leonora Rivera, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Saddle Brook, NJ
National Provider Identifier
1518955657
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA04738900 Issued in NJ
Practice address
300 Market St
Saddle Brook, NJ 07663-5309
Phone
(201) 368-6019
NPI assigned
Oct 12, 2005
Last updated
Feb 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA04738900 NJ Primary

Addresses

Primary practice location

300 Market St
Saddle Brook, NJ 07663-5309

Mailing address

4716 Old Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 972-1139

Other identifiers 1

IdentifierTypeStateIssuer
0051101MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000062 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - General Practice 5395715999 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kessler Professional Services LLC CurrentSince Jul 1, 2004 Accepting new patients

Locations

300 Market St
Saddle Brook, NJ 07663
Phone (201) 368-6000

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1518955657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1139",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARKET ST",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635309",
            "telephone_number": "201-368-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LEONORA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA04738900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saddle Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.