NPIMap

Individual provider Active NPI

John Edwin Rivera Jr., M.D.

  • Family Medicine Physician
  • Milldale, CT
National Provider Identifier
1720044811
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042567 Issued in CT
Practice address
PO Box 770
Milldale, CT 06467-0770
Phone
(860) 621-5554
Fax
(860) 621-3833
NPI assigned
Apr 26, 2006
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 042567 CT
Family Medicine Physician 207Q00000X 042567 CT Primary

Addresses

Primary practice location

PO Box 770
Milldale, CT 06467-0770

Mailing address

20 York St
CB-2041
New Haven, CT 06504-8900
Phone (203) 688-4748

Other identifiers 1

IdentifierTypeStateIssuer
042567OtherCTSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040728000950 CT Practitioner - Family Practice 6204806193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1753 Meriden Waterbury Rd
PO Box 770
Milldale, CT 06467-0770
Phone (860) 621-5554

PO Box
Suite 770
Milldale, CT 06467-0770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.44 of 100Reported as group
Quality
73.92
Improvement activities
40
Cost
79.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042567CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John E. Rivera Jr., M.D., LLC Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
John E. Rivera, M.D., P.C. Family Medicine PastSince Oct 21, 2025 Accepting new patients
Ynh Medical Services PC Hospitalist Past Accepting new patients
Mill Hill Medical Consultants Inc Hospitalist Past Accepting new patients

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1720044811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065048900",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "MILLDALE",
            "state": "CT",
            "postal_code": "064670770",
            "telephone_number": "860-621-5554",
            "fax_number": "860-621-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JOHN",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "042567",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "042567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "042567",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milldale, CT

Sources for this page

Verify at the official NPI Registry.