Individual provider Active NPI

Olivia Rivarola, COTA/L

  • Pediatric Occupational Therapist
  • Kenmore, NY
National Provider Identifier
1568208858
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
011596 Issued in NY
Practice address
3767 Delaware Ave
Kenmore, NY 14217-1040
Phone
(716) 874-6175
NPI assigned
Jul 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 64-P129170-01 NY
Pediatric Occupational Therapist 225XP0200X 011596 NY Primary

Addresses

Primary practice location

3767 Delaware Ave
Kenmore, NY 14217-1040

Mailing address

2 Pine Valley CT
West Seneca, NY 14224-4156
Phone (716) 574-2039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011596NYMDPediatric Occupational Therapist
64-P129170-01NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physical & Occupational Therapists, PLLC PastSince Jul 7, 2024 Accepting new patients

Organizations & group practices 1

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": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1568208858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PINE VALLEY CT",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142244156",
            "telephone_number": "716-574-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171040",
            "telephone_number": "716-874-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAROLA",
        "first_name": "OLIVIA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "64-P129170-01",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "011596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2024; 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.