CARLOS G RIVERA M.D., PC
NPI 1447696216
Exclusive Provider Organization in Long Branch, NJ
About Carlos G Rivera M.d., Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARLOS G RIVERA M.D., PC (NPI 1447696216) is a healthcare organization registered as an exclusive provider organization in Long Branch, New Jersey and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through March 3, 2028 and lists Susan Swoope, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
Other Identifiers 3
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 31D0941981
Carlos G Rivera MD PC · Long Branch, NJOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LONG BRANCH, NJ 07740
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carlos G Rivera M.D., PC's NPI number?
The NPI number for Carlos G Rivera M.D., PC is 1447696216. It was assigned to this organization in the NPPES registry on May 20, 2013.
Where is Carlos G Rivera M.D., PC located?
Carlos G Rivera M.D., PC is located at 9 Memorial Pkwy, Long Branch, NJ 07740. The listed phone number is (732) 728-7010.
What is Carlos G Rivera M.D., PC's specialty?
The primary specialty registered for this NPI is Exclusive Provider Organization with taxonomy code 302F00000X.
Does Carlos G Rivera M.D., PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 31D0941981) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Carlos G Rivera M.D., PC accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Carlos G Rivera M.D., PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Carlos G Rivera M.D., PC was last updated on May 20, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.
