Individual provider Active NPI

Oliver Rivera, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1194231829
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.023299 Issued in IL
Practice address
1640 W Roosevelt Rd RM 336
Chicago, IL 60608-1316
Phone
(312) 413-8046
NPI assigned
Dec 18, 2017
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.023299 IL Primary
Sports Physical Therapist 2251S0007X NU
Orthopedic Physical Therapist 2251X0800X NU

Addresses

Primary practice location

1640 W Roosevelt Rd RM 336
Chicago, IL 60608-1316

Mailing address

739 W Cornelia Ave
N2
Chicago, IL 60657-2460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807001158 IL Practitioner - Physical Therapist in Private Practice 0042757122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 W Roosevelt
Room 336 Mc628
Chicago, IL 60606-1316
Phone (312) 996-6695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince May 26, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Physical Therapist CurrentSince May 26, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1640 W Roosevelt Rd
#727
Chicago, IL 60608
Phone (312) 413-1871

1640 W Roosevelt Rd
Rm 336
Chicago, IL 60608
Phone (312) 413-1563

5525 S Pulaski Rd
Chicago, IL 60629
Phone (773) 432-0100

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

Organizations & group practices 4

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": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1194231829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 W CORNELIA AVE",
            "address_2": "N2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 W ROOSEVELT RD RM 336",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081316",
            "telephone_number": "312-413-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "OLIVER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.023299",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.