Active NPI
Jaime Hernan Rivera, M.D.
- Pediatrics Physician
- Poughkeepsie, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 131829
- Practice address
- 104 Fulton Ave
Poughkeepsie, NY 12603-2808 - Phone
- (845) 452-1700
- NPI assigned
- Dec 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 131829 | NY | |
| Pediatrics Physician | 208000000X | C1-0002870 | DE | |
| Pediatrics Physician | 208000000X | 131829 | NY | Primary |
Addresses
Primary practice location
104 Fulton Ave
Poughkeepsie, NY 12603-2808
Mailing address
104 Fulton Ave
Poughkeepsie, NY 12603-2808
Phone (845) 452-1700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000028901 | Medicaid | DE | |
| 00249707 | Medicaid | NY |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0002870 | DE | MD | Pediatrics Physician |
| 131829 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Services of New York, P.C. | Emergency Medicine | Current | Accepting new patients |
| Essen Medical Urgicare, PLLC | Current | Accepting new patients | |
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Essen Medical Associates,PC | Current | Accepting new patients | |
| Betances Health Center | Past | Accepting new patients | |
| Betances Health Center | Past | Accepting new patients |
Locations
2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400
1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366
8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207
8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400
45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131
Organizations & group practices 7
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.
-
- Emergency Medicine Physician
- Poughkeepsie, NY
- NPI 1093759847
-
- Legal Medicine
- Bronx, NY
- NPI 1366418709
-
- Urgent Care Clinic/Center
- Bronx, NY
- NPI 1841607298
-
- Podiatrist
- Bronx, NY
- NPI 1720799158
-
- Legal Medicine (M.D./D.O.) Physician
- Jamaica, NY
- NPI 1700023926
-
- Federally Qualified Health Center (FQHC)
- Brooklyn, NY
- NPI 1699137257
-
- Registered Nurse
- New York, NY
- NPI 1831269273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553126400000",
"number": "1811057193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 FULTON AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032808",
"telephone_number": "845-452-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 FULTON AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032808",
"telephone_number": "845-452-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JAIME",
"middle_name": "HERNAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-09",
"last_updated": "2019-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "131829",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0002870",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "131829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000028901",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00249707",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Poughkeepsie, NY
- River Valley Care Center, Inc.
- River Valley Speech and Language Intervention Services
- Amber Judith Rivera, PA-C
- Carmen Milagros Rivera, MSW LCSW
- Christopher Rivera
- Jennifer Rivera, LPN
- Nathalie Rivera, DMD
- Riverside Chiropractic of Ny PC
- Riverside Medical Practice, PLLC
- Riverview Center for Psychiatric Medicine, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.