Kassandra Rivera

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

03314801 Issued in NY

Practice address

2335 Gerritsen Ave
Brooklyn, NY 11229-5701

Phone

(718) 834-0597

NPI assigned

Apr 19, 2019

Reactivated

Nov 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Ahrc Nyc

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1255715850
  NPD (past)

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1659934115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BYRAM AVE UNIT 5",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078014537",
            "telephone_number": "469-338-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 GERRITSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295701",
            "telephone_number": "718-834-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "deactivation_date": "2023-09-19",
        "reactivation_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01164700",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "03314801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marisela Rivera
• Jennyleah Rivera
• Jorge Rivera Jr., CASAC
• Juan A Rivera, CASAC-T
• Juan Marin Rivera
• Kassandra Mia Rivera
• Laura Maria Rivera, R.PH.
• Lavarn Rivera
• Lorena Rivera, MA
• Luis Rivera

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.