Individual provider Active NPI

Steve Rivizziano, PHYSICAL THERAPIST

  • Physical Therapist
  • Camillus, NY
National Provider Identifier
1003086877
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01694 Issued in NY
Practice address
4050 Milton Avenue
Camillus, NY 13031
Phone
(315) 672-5063
Fax
(315) 672-5461
NPI assigned
Mar 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01694 NY Primary

Addresses

Primary practice location

4050 Milton Avenue
Camillus, NY 13031

Mailing address

421 Swansea Avenue
Syracuse, NY 13206
Phone (315) 672-5063

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
010694NYMDMental Health Counselor
01694NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Finger Lakes Chiropractic P.C PastSince Dec 18, 2022 Accepting new patients
Advance Physical Therapy Physical Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1003086877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SWANSEA AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13206",
            "telephone_number": "315-672-5063",
            "fax_number": "315-672-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 MILTON AVENUE",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "13031",
            "telephone_number": "315-672-5063",
            "fax_number": "315-672-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVIZZIANO",
        "first_name": "STEVE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "01694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.