Carla Renee Rivera, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5197 Issued in HI

Practice address

1029 Kapahulu Ave
Ste 401
Honolulu, HI 96816-1332

Phone

(410) 831-3226

Fax

(410) 677-0883

NPI assigned

Jun 8, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, VA, DC3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Proflex Physical Therapy of Maryland, LLC.

  • Physical Medicine & Rehabilitation Physician
  • Waldorf, MD
  • NPI 1558714824

  DC, Physical Therapist, VA

  Medicare reassignment Care Compare group NPD
• Professional Physical Therapy LLC

  • Physical Therapist
  • Dumfries, VA
  • NPI 1114321619
  Medicare reassignment NPD
• Fitness Forum of Maryland, LLC

  • Occupational Therapist
  • Annapolis, MD
  • NPI 1821853441
  NPD
• Proflex Physical Thearpy of Maryland, LLC

  • Physical Medicine & Rehabilitation Physician
  • Stafford, VA
  • NPI 1700763851
  NPD
• Lake Ridge Physical Therapy, LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1871598417
  NPD (past)

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1053547893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10327",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968160327",
            "telephone_number": "808-739-1977",
            "fax_number": "808-739-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 KAPAHULU AVE",
            "address_2": "STE 401",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968161332",
            "telephone_number": "410-831-3226",
            "fax_number": "410-677-0883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Circle",
            "address_2": "Fort Carson MEDDAC- Building #T7530 Physical Therapy",
            "address_purpose": "LOCATION",
            "city": "Fort Carson",
            "state": "CO",
            "postal_code": "80913",
            "country_code": "US",
            "telephone_number": "719-526-7048",
            "fax_number": "719-526-7072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "CARLA",
        "middle_name": "RENEE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT5197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecil Frank Riter, DDS
• River Kim LLC
• Amanda Rivera
• Amberlynn Waialoe Rivera, LSW
• Brianna Rivera, MA
• Charles Rivera, BSW, CSAC, CCJP
• Christine Joy Acorda Rivera
• Diane Kahealani Rivera, LMT
• Jennifer Nerves Rivera, M.D.
• Kahealani K Rivera, MD

• Physical Therapist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.