Physical Medicine & Rehab of Brevard, P.a.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PHYSICAL MEDICINE & REHAB OF BREVARD, P.A.

Practice address

840 Executive LN Ste 120
Rockledge, FL 32955-3519

Phone

(321) 449-1112

Fax

(321) 449-1172

NPI assigned

Dec 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Rivera, M.D.NPI 1114033511

Title

President

Phone

(321) 449-1112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antonio Rivera, MD

  • Physical Medicine & Rehabilitation Physician
  • Rockledge, FL
  • NPI 1114033511
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1609145580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 EXECUTIVE LN STE 120",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553519",
            "telephone_number": "321-449-1112",
            "fax_number": "321-449-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 EXECUTIVE LN STE 120",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553519",
            "telephone_number": "321-449-1112",
            "fax_number": "321-449-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE & REHAB OF BREVARD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-449-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elysa Petersen, LMHC
• Pfk513 LLC
• Nina Teresa Phelps, FNP-C
• Patricia June Philbrick, APRN
• Hance Phillips
• Shannon Piatek, PHARM.D.
• Maggie Lin Pierce
• Meagan Iree Pifer, MSW, RCSWI
• Michelle Pillado
• Pineapple Garden Inc

• Physical Medicine & Rehabilitation Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.