Individual provider Active NPI

Austin Ricardo Rivera

  • Peer Specialist
  • Brecksville, OH
National Provider Identifier
1972261204
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
000877 Issued in OH
Practice address
6640 Westview Dr
Brecksville, OH 44141-2902
Phone
(216) 233-9290
NPI assigned
Dec 3, 2021
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 000877 OH Primary

Addresses

Primary practice location

6640 Westview Dr
Brecksville, OH 44141-2902

Mailing address

6640 Westview Dr
Brecksville, OH 44141-2902
Phone (216) 233-9290

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

State licenses

LicenseStateTypeSpecialty
000877OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1972261204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 WESTVIEW DR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412902",
            "telephone_number": "216-233-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 WESTVIEW DR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412902",
            "telephone_number": "216-233-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "AUSTIN",
        "middle_name": "RICARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "000877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.