Individual provider Active NPI

Gladys Rivera Vazquez, RPT

  • Physical Therapist
  • Barceloneta, PR
National Provider Identifier
1659454460
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0936 Issued in PR
Practice address
Carr 2 KM 55.2 Barrio Palenque
Barceloneta, PR 00617-0430
Phone
(787) 846-4121
Fax
(787) 846-5661
NPI assigned
Oct 23, 2006
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0936 PR Primary
Interpreter 171R00000X 00936 PR

Addresses

Primary practice location

Carr 2 KM 55.2 Barrio Palenque
Barceloneta, PR 00617-0430

Mailing address

Urb. Palmas del Sur 173
P.O. Box 1220
Morovis,, PR 00687-1220
Phone (787) 862-0869

Other practice location 1

carr #173
urb palmas bo morovis sur
Morovis, PR 00687-1220
Phone (787) 862-0869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060116000035 PR Practitioner - Physical Therapist in Private Practice 2567486707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Puerto Rico School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica de Terapia Fisica Y Rehabilitacion Genesis LLCGroup PAC ID 4880124098, 3 clinicians

Practice addresses (Care Compare)

Carr 2 KM
2 Bo Palenque
Barceloneta, PR 00617-0430
Phone (787) 846-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00936PRMDInterpreter
0936PRMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica de Terapia Fisica Y Rehabilitacion Genesis LLC Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Luz C Butler Moya Single Specialty PastSince Dec 1, 2024 Accepting new patients

Organizations & group practices 3

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1659454460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. PALMAS DEL SUR 173",
            "address_2": "P.O. BOX 1220",
            "city": "MOROVIS,",
            "state": "PR",
            "postal_code": "006871220",
            "telephone_number": "787-862-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2 KM 55.2 BARRIO PALENQUE",
            "city": "BARCELONETA",
            "state": "PR",
            "postal_code": "006170430",
            "telephone_number": "787-846-4121",
            "fax_number": "787-846-5661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "carr #173",
            "address_2": "urb palmas bo morovis sur",
            "address_purpose": "LOCATION",
            "city": "Morovis",
            "state": "PR",
            "postal_code": "006871220",
            "country_code": "US",
            "telephone_number": "787-862-0869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA VAZQUEZ",
        "first_name": "GLADYS",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "0936",
            "primary": true
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "",
            "desc": "Interpreter",
            "state": "PR",
            "license": "00936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barceloneta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.