Edgardo Rivera Lopez, PT, DPT, CSCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

1362473 Issued in TX

Practice address

4301 Broadway
San Antonio, TX 78209-6318

Phone

(210) 829-6017

NPI assigned

Jul 19, 2022

Last updated

Jul 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

• University of the Incarnate Word

  dba Nursing Cardinal Clinic

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1033591706
  NPD

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1477288900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N LOOP 1604 E",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321276",
            "telephone_number": "787-414-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 BROADWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096318",
            "telephone_number": "210-829-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA LOPEZ",
        "first_name": "EDGARDO",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1362473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1362473",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EMR",
            "affiliation": "N",
            "address_1": "4301 Broadway",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782096318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Helena Rivera Bali, CFY-SLP
• Rivera Behavioral Health PLLC (Rivera Behavioral Health)
• Rivera Counseling & Associates PLLC
• Diana Rivera Espino
• Esther A Rivera Gambaro, M.D.
• Miriam Sugei Rivera Lopez
• Cristy Rivera Mendez
• Nilka Juliana Rivera Ortiz, PSYD
• Octavio Rivera Sanchez
• Wanda Rivera Sloan, L.P.C

• Sports Physical Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Sports Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.