Active NPI
Aksim Gadiel Rivera, M.D.
- Vascular Surgery Physician
- Bronx, NY
National Provider Identifier
1841586971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 271303
- Practice address
- 1400 Pelham Pkwy S
Building # 1. Suite 529W
Bronx, NY 10461-1138 - Phone
- (718) 918-5541
- NPI assigned
- Jun 28, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 036128128 | IL | |
| Vascular Surgery Physician | 2086S0129X | 271303 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Building # 1. Suite 529W
Bronx, NY 10461-1138
Mailing address
555 W Kinzie St
Apt 3312
Chicago, IL 60654-5727
Phone (787) 602-8370
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170308002774 | NY | Order and Referring Only - Vascular Surgery | 9133403272 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036128128 | IL | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- arivera836974@nychhc.direct-ci.com
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.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1841586971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 W KINZIE ST",
"address_2": "APT 3312",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606545727",
"telephone_number": "787-602-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"address_2": "BUILDING # 1. SUITE 529W",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-918-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "AKSIM",
"middle_name": "GADIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-28",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "IL",
"license": "036128128",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NY",
"license": "271303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.