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DR. JOHN EDWIN RIVERA JR. M.D.
NPI 1720044811
Family Medicine in Milldale, CT

Active since April 26, 2006PECOS EnrolledAccepts Medicare Assignment
58.33/100
CMS Quality Rating
PO BOX 770, MILLDALE, CT 06467(860) 621-5554(860) 621-3833 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. John Edwin Rivera Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN EDWIN RIVERA JR. M.D. (NPI 1720044811) is an individual family medicine provider in Milldale, Connecticut, licensed in Connecticut (042567) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Warren Alpert Medical School Of Brown University (2001).

NPPES Registry Identity

NPI1720044811
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JOHN EDWIN RIVERA JR.Credential: M.D.
Location AddressPO BOX 770Milldale, CT 06467-0770
Mailing Address20 York St, Cb-2041New Haven, CT 06504-8900 · (203) 688-4748 · Fax (203) 688-4740
Phone(860) 621-5554
Fax(860) 621-3833
Sole ProprietorNo
Medical School CMSWarren Alpert Medical School Of Brown UniversityGraduated 2001
Enumeration DateApril 26, 2006
Last NPPES UpdateMarch 31, 2026
NPPES CertifiedMarch 31, 2026
✔ NPI 1720044811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CT · 042567
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 042567 (CT)
PO BOX 770, Milldale, CT 06467
Open in Google Maps ↗

Other Identifiers 1

Other042567CT · State Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. John Edwin Rivera Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204806193
PECOS Enrollment IDI20040728000950
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
251 services150 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
229 services151 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
128 services128 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
25 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
23 services23 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06467 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

58.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.13
Improvement Activities0
Cost98.28

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
90%181 patients4/55-star benchmark: 99%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%12,187 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
17%1,543 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
4%2,420 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
68%505 patients4/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
30%1,498 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
32%2,420 patients2/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 3% · 505 patients
9%505 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers13 claims44 services$5.82 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers12 claims36 services$24.49 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 John Rivera's NPI number?

The NPI number for John Rivera is 1720044811. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Where is John Rivera located?

John Rivera practices at PO Box 770, Milldale, CT 06467. The listed phone number is (860) 621-5554.

What is John Rivera's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is John Rivera enrolled in Medicare?

Yes. John Rivera is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for John Rivera was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.