Individual provider Active NPI

Madeline Rafaelano Rivas, DPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1154145977
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216824 Issued in VA
Practice address
6856 Richmond Hwy
Alexandria, VA 22306
Phone
(571) 348-1201
Fax
(571) 302-8633
NPI assigned
Nov 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 2305216824 VA Primary

Addresses

Primary practice location

6856 Richmond Hwy
Alexandria, VA 22306

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241122003673 DC Practitioner - Physical Therapist in Private Practice 4587199880 Reassigns benefits to 1 organization
I20250110000994 VA Practitioner - Physical Therapist in Private Practice 4587199880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians
Oncology Rehab and Wellness Resources LLCGroup PAC ID 2961647847, 4 clinicians

Practice addresses (Care Compare)

11662 Sudley Manor Dr
50B
Manassas, VA 20109-2842
Phone (571) 321-5720

43330 Junction PLZ
Suite 122
Ashburn, VA 20147-3407
Phone (703) 972-1040

44160 Scholar PLZ
Suite 390
Lansdowne, VA 20176-3461
Phone (703) 789-0367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305216824VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Rehab and Wellness Resources, LLC Physical Therapist CurrentSince Jan 19, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Nov 6, 2024 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

44160 Scholar Plz
Ste 390
Leesburg, VA 20176
Phone (703) 789-0367

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

Organizations & group practices 3

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": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1154145977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22306",
            "telephone_number": "571-348-1201",
            "fax_number": "571-302-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAELANO RIVAS",
        "first_name": "MADELINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.