Individual provider Active NPI

Maria Cecilia Rivera-Amisola, MD

  • Developmental - Behavioral Pediatrics Physician
  • Dayton, OH
National Provider Identifier
1952407645
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
35.083964 Issued in OH
Practice address
1010 Valley St
Dayton, OH 45404-2070
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.083964 OH
Developmental - Behavioral Pediatrics Physician 2080P0006X 35.083964 OH Primary

Addresses

Primary practice location

1010 Valley St
Dayton, OH 45404-2070

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-3000

Other identifiers 1

IdentifierTypeStateIssuer
2462071MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20210413001484 OH Practitioner - Pediatric Medicine 4789588070 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
001781NYMDMidwife
35.083964OHMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children's Specialty Physicians, Inc. Pediatrics CurrentSince Mar 15, 2021 Accepting new patients
Dayton Children's Specialty Physicians, Inc. Pediatrics CurrentSince Mar 15, 2021 Accepting new patients
North Shore-Lij Medical PC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

1010 Valley St
Dayton, OH 45404
Phone (937) 641-3185

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1952407645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 VALLEY ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042070",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-AMISOLA",
        "first_name": "MARIA",
        "middle_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.083964",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OH",
            "license": "35.083964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2462071",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.