Individual provider Active NPI

Kathryn Rivera

  • Social Worker
  • Hauppauge, NY
National Provider Identifier
1588424428
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
90 Adams Ave
Hauppauge, NY 11788-3631
Phone
(631) 952-3333
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

90 Adams Ave
Hauppauge, NY 11788-3631

Mailing address

1113 Lake Dr
Medford, NY 11763-4620
Phone (631) 880-2611

Other practice location 1

1113 Lake Dr
Medford, NY 11763-4620
Phone (631) 880-2611

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1588424428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 LAKE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634620",
            "telephone_number": "631-880-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ADAMS AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883631",
            "telephone_number": "631-952-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NY",
            "postal_code": "117634620",
            "country_code": "US",
            "telephone_number": "631-880-2611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.