Individual provider Active NPI

Melany M Rivera-Maldonado, PH.D.

  • Psychologist
  • Jersey City, NJ
National Provider Identifier
1821630120
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00610400 Issued in NJ
Practice address
101 Hudson St Ste 2175
Jersey City, NJ 07302-3915
Phone
(551) 209-2557
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 023237-01 NY
Psychologist 103T00000X 35SI00610400 NJ Primary

Addresses

Primary practice location

101 Hudson St Ste 2175
Jersey City, NJ 07302-3915

Mailing address

101 Hudson St Ste 2100
Jersey City, NJ 07302-3929

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00610400NJMDPsychologist
023237-01NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Round Room Psychology, LLC CurrentSince Oct 20, 2019 Accepting new patients

Locations

101 Hudson St
Ste 2175
Jersey City, NJ 07302
Phone (551) 209-2557

101 Hudson St
Ste 2100
Jersey City, NJ 07302
Phone (917) 608-1142

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1821630120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HUDSON ST STE 2100",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HUDSON ST STE 2175",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023915",
            "telephone_number": "551-209-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-MALDONADO",
        "first_name": "MELANY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023237-01",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00610400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.