Individual provider Active NPI

Javier Rivadeneyra, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1144118159
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308253 Issued in CA
Practice address
520 S Virgil Ave Ste 201
Los Angeles, CA 90020-1425
Phone
(213) 365-0023
Fax
(323) 978-4342
NPI assigned
Jun 26, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 308253 CA Primary

Addresses

Primary practice location

520 S Virgil Ave Ste 201
Los Angeles, CA 90020-1425

Mailing address

520 S Virgil Ave Ste 201
Los Angeles, CA 90020-1425
Phone (213) 378-2563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250904003904 CA Practitioner - Physical Therapist in Private Practice 8022510551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choice Physical Therapy and Rehab PCGroup PAC ID 2668745340, 4 clinicians
Ryu Physical Therapy PCGroup PAC ID 1355563602, 6 clinicians

Practice addresses (Care Compare)

18771 Colima Rd
Rowland Heights, CA 91748-2949
Phone (626) 269-0706

520 S Virgil Ave
Suite 201
Los Angeles, CA 90020-1425
Phone (213) 365-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308253CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Physical Therapy & Rehab PC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Ryu Physical Therapy, PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3251 W 6th St
Ste 410
Los Angeles, CA 90020
Phone (213) 388-0182

520 S Virgil Ave
Ste 201
Los Angeles, CA 90020
Phone (213) 365-0023

18771 Colima Rd
Rowland Hghts, CA 91748
Phone (626) 269-0706

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1144118159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201425",
            "telephone_number": "213-378-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201425",
            "telephone_number": "213-365-0023",
            "fax_number": "323-978-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVADENEYRA",
        "first_name": "JAVIER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.