MARISA RIVERSO MD
NPI 1972922664
Pediatrics - Pediatric Emergency Medicine in Glen Mills, PA

Q: What is Marisa Riverso's NPI number?

The NPI number for Marisa Riverso is 1972922664. It was assigned to this individual provider in the NPPES registry on April 10, 2014.

Q: What is Marisa Riverso's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Marisa Riverso was last updated on May 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.

Active since April 10, 2014PECOS EnrolledAccepts Medicare Assignment

101 APPLIED BANK BLVD STE 11, GLEN MILLS, PA 19342(484) 800-8630(484) 800-8635 Get Directions Write a Review

NPPES record last updated: May 6, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2019, Jan 29, 2019 (2 updates tracked since 2019).

On this page

About Marisa Riverso Md NPPES

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

MARISA RIVERSO MD (NPI 1972922664) is an individual pediatric emergency medicine provider in Glen Mills, Pennsylvania, licensed in Pennsylvania (MD461999) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of State University Of Ny Upstate Medical University (2014).

NPPES Registry Identity

NPI1972922664

Entity TypeIndividualFemale

Primary Taxonomy2080P0204X

Provider Legal NameMARISA RIVERSOCredential: MD

Location Address101 APPLIED BANK BLVD STE 11Glen Mills, PA 19342

Mailing AddressPo Box 191Rockland, DE 19732-0191

Phone(484) 800-8630

Fax(484) 800-8635

Sole ProprietorNo

Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2014

Enumeration DateApril 10, 2014

Last NPPES UpdateMay 6, 20192 updates tracked since enumeration

✔ NPI 1972922664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in PA · MD461999

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedEmergency MedicineTaxonomy 207P00000X · License C1-0013071 (DE)

Also ListedPediatricsTaxonomy 208000000X · License MD461999 (PA), C1-0013071 (DE)

101 APPLIED BANK BLVD STE 11, Glen Mills, PA 19342

Open in Google Maps ↗

Secondary Practice Locations 2

Location 11600 Rockland Rd Ste 2B80Wilmington, DE 19803-3607 · Phone (302) 651-5874

Location 2101 Applied Bank Blvd Ste 11Glen Mills, PA 19342 · Phone (484) 800-8630 · Fax (484) 800-8635

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

Marisa Riverso Md 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 ID8729385778

PECOS Enrollment IDI20190702002313

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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON DOYLE TIEDEKEN MD

Pediatrics

101 APPLIED BANK BLVD STE 11, NEMOURS DUPONT PEDIATRICS, GLEN MILLS URGENT CARE
GLEN MILLS, PA 19342

Delaware County (484) 800-8630

DR. TEJAL MODY M.D.

Radiology (Pediatric Radiology)

101 APPLIED BANK BLVD STE 11, NEMOURS DUPONT PEDIATRICS, GLEN MILLS
GLEN MILLS, PA 19342

Delaware County (484) 800-8630

DR. KAI ADIA TURNER DO

Pediatrics

101 APPLIED BANK BLVD STE 11
GLEN MILLS, PA 19342

Delaware County (484) 800-8630

MS. JACLYN MARIE DEMATTEIS PA-C

Physician Assistant

101 APPLIED BANK BLVD STE 11
GLEN MILLS, PA 19342

Delaware County (484) 800-8630

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 Marisa Riverso's NPI number?

The NPI number for Marisa Riverso is 1972922664. It was assigned to this individual provider in the NPPES registry on April 10, 2014.

Where is Marisa Riverso located?

Marisa Riverso practices at 101 Applied Bank Blvd Ste 11, Glen Mills, PA 19342. The listed phone number is (484) 800-8630.

What is Marisa Riverso's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Marisa Riverso enrolled in Medicare?

Yes. Marisa Riverso 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 Marisa Riverso was last updated on May 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.