Marcus Richard Rivera, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

255782 Issued in NY

Practice address

725 Irving Ave
Crouse Pob Ste. 805
Syracuse, NY 13210-1603

Phone

(315) 464-8444

Fax

(315) 464-8445

NPI assigned

Jul 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Gastroenterology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Service GroupGroup PAC ID 9931007200, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrivera6143@direct.upstate.edu

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.

• Pediatric Service Group

  • Pediatrics Physician
  • Syracuse, NY
  • NPI 1770539066
  Medicare reassignment Care Compare group NPD
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  NPD (past)
• University OB/GYN Associates

  • Gynecology Physician
  • Syracuse, NY
  • NPI 1235170150
  NPD (past)

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

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1891993218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "CROUSE POB STE. 805",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-8444",
            "fax_number": "315-464-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "CROUSE POB STE. 805",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-8444",
            "fax_number": "315-464-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARCUS",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "255782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02888902",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Rivara
• Natalie Horn Rivard, FNP
• River Meadows, LLC
• Amber Marie Rivera, NP
• Aubrianna Sue Rivera, MSW
• Melissa Rivera
• Sandra Enid Rivera, PT
• Yadira Rivera
• Susan S Rivito, MST
• Rabia Rizwana, M.D.

• Pediatric Gastroenterology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Pediatric Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.