Raymond Manuel Rivera Vergara

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD478007 Issued in PA

Practice address

4720 Pine St Apt C3
Philadelphia, PA 19143-1840

Phone

(267) 595-1655

Fax

(302) 233-7475

NPI assigned

Oct 7, 2015

Sex

Male

Sole proprietor

Yes

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1851761555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 PINE ST APT C3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431840",
            "telephone_number": "267-595-1655",
            "fax_number": "302-233-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PINE ST APT C3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431840",
            "telephone_number": "267-595-1655",
            "fax_number": "302-233-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA VERGARA",
        "first_name": "RAYMOND",
        "middle_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD478007",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Rivenbark
• Ariana Rivens, PHD
• River Wards Wellness Collective
• Alicia M Rivera Jones, LCSW
• Stephanie M Rivera Morales, MD
• Jorge Alberto Rivera-Colon, MD
• Belinda Natalia Rivera-Lebron, MD
• Karen Rivera-Seda, LPC, MFT, NCC
• Viviana B Rivera-Vargas, PSY.D.
• Carissa Marie Rivera

• General Practice Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.

Verify at the official NPI Registry.