Individual provider Active NPI

Carlos Riveros, DPT

  • Physical Therapist
  • Pinellas Park, FL
National Provider Identifier
1568775476
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25688 Issued in FL
Practice address
4820 Park Blvd
Suite E
Pinellas Park, FL 33781-3534
Phone
(727) 369-6355
NPI assigned
Jul 20, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT25688 FL Primary

Addresses

Primary practice location

4820 Park Blvd
Suite E
Pinellas Park, FL 33781-3534

Mailing address

9125 US Highway 19 N
Pinellas Park, FL 33782-5406
Phone (727) 369-6355

Other practice location 1

9021 Oakhurst Rd Ste A
Seminole, FL 33776-2156
Phone (727) 369-6355

Other practice location 2

9125 US Highway 19 N
Pinellas Park, FL 33782-5406
Phone (727) 369-6355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100917000953 FL Practitioner - Physical Therapist in Private Practice 8729103403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life in Motion Physical and Hand TherapyGroup PAC ID 8527298140, 3 clinicians

Practice addresses (Care Compare)

9125 US Hwy 19 N
Pinellas Park, FL 33782-5406
Phone (727) 369-6355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life in Motion Physical & Hand Therapy CurrentSince Dec 17, 2013 Accepting new patients
Life in Motion Physical & Hand Therapy Physical Therapist PastSince Jul 24, 2022 Accepting new patients

Locations

4820 Park Blvd N
Ste E
Pinellas Park, FL 33781
Phone (727) 369-6355

9125 US Highway 19 N
Pinellas Park, FL 33782
Phone (727) 369-6355

9021 Oakhurst Rd
Ste A
Seminole, FL 33776
Phone (727) 369-6355

Organizations & group practices 2

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568775476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 US HIGHWAY 19 N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337825406",
            "telephone_number": "727-369-6355",
            "fax_number": "727-362-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 PARK BLVD",
            "address_2": "SUITE E",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813534",
            "telephone_number": "727-369-6355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9021 Oakhurst Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Seminole",
            "state": "FL",
            "postal_code": "337762156",
            "country_code": "US",
            "telephone_number": "727-369-6355",
            "fax_number": "727-362-4766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9125 US Highway 19 N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337825406",
            "country_code": "US",
            "telephone_number": "727-369-6355",
            "fax_number": "727-362-4766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVEROS",
        "first_name": "CARLOS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.