Individual provider Active NPI

Lesley Linda Rivera, PT, DPT

  • Physical Therapist
  • Yorba Linda, CA
National Provider Identifier
1245836618
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299430 Issued in CA
Practice address
21255 Trail RDG
Yorba Linda, CA 92886-7806
Phone
(909) 265-3584
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 299430 CA Primary

Addresses

Primary practice location

21255 Trail RDG
Yorba Linda, CA 92886-7806

Mailing address

21255 Trail RDG
Yorba Linda, CA 92886-7806
Phone (909) 265-3584

Other names 1

  • Lesley Linda Hicks Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210420000348 CA Practitioner - Physical Therapist in Private Practice 2163830704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peter S Birnbaum D O IncGroup PAC ID 3375620446, 2 clinicians

Practice addresses (Care Compare)

1211 W la Palma Ave
Suite 506
Anaheim, CA 92801-2812
Phone (714) 491-3670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Protea Physical Therapy & Wellness Physical Therapist Current Accepting new patients
Peter S Birnbaum DO Inc CurrentSince Jun 25, 2024 Accepting new patients
Restorative Therapy Associates Physical Therapist CurrentSince Apr 13, 2022 Accepting new patients

Locations

1211 W La Palma Ave
Ste 506
Anaheim, CA 92801
Phone (714) 491-3670

1211 W La Palma Ave
Ste 509
Anaheim, CA 92801

101 Pacifica
Ste 270
Irvine, CA 92618
Phone (949) 333-3833

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFHHCD/Endpoint/FFHHCD

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1245836618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21255 TRAIL RDG",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928867806",
            "telephone_number": "909-265-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21255 TRAIL RDG",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928867806",
            "telephone_number": "909-265-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LESLEY",
        "middle_name": "LINDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLEY",
            "last_name": "HICKS",
            "middle_name": "LINDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.