Individual provider Active NPI

Dianelza R. Chang-Rivera

  • Developmental Therapist
  • Miami, FL
National Provider Identifier
1629251673
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
14221 SW 120TH St.
Suite 210
Miami, FL 33186-4224
Phone
(786) 391-0818
Fax
(786) 609-2019
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

14221 SW 120TH St.
Suite 210
Miami, FL 33186-4224

Mailing address

14221 SW 120TH St.
Suite 210
Miami, FL 33186-4224
Phone (786) 391-0818

Other identifiers 1

IdentifierTypeStateIssuer
811905800MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Services LLC CurrentSince Mar 31, 2024 Accepting new patients
Children'S Health & Educational MGT Developmental Therapist PastSince Jan 17, 2022 Accepting new patients

Locations

14221 SW 120th St
Ste 210
Miami, FL 33186
Phone (786) 391-2935

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1629251673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14221 SW 120TH ST.",
            "address_2": "SUITE 210",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864224",
            "telephone_number": "786-391-0818",
            "fax_number": "786-609-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 SW 120TH ST.",
            "address_2": "SUITE 210",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864224",
            "telephone_number": "786-391-0818",
            "fax_number": "786-609-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG-RIVERA",
        "first_name": "DIANELZA",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811905800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.