Active NPI
Kristian Rivera, DPT
- Physical Therapist
- Dallas, TX
National Provider Identifier
1679180269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1337573
- Practice address
- 4801 S Buckner Blvd
Dallas, TX 75227-2373 - Phone
- (214) 381-7700
- Fax
- (972) 707-0021
- NPI assigned
- Sep 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1337573 | TX | Primary |
Addresses
Primary practice location
4801 S Buckner Blvd
Dallas, TX 75227-2373
Mailing address
5948 Travertine LN Apt 223
Fort Worth, TX 76137-7089
Phone (915) 215-0517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5520 Sycamore School Rd
Suite 230
Fort Worth, TX 76123-3062
Phone (817) 423-1621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportherapy LLC | Physical Therapist | Current | Accepting new patients |
| Sportherapy Southwest, PC | Physical Therapist | Past | Accepting new patients |
Locations
3803 E US Highway 377
#200
Granbury, TX 76049
Phone (682) 260-5210
965 Hilltop Dr
Weatherford, TX 76086
Phone (817) 370-9891
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 and National Provider Directory roles.
-
dba Vista Physical Therapy
- Multi-Specialty Clinic/Center
- Lake Worth, TX
- NPI 1326753377
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Fort Worth, TX
- NPI 1801812698
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1679180269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5948 TRAVERTINE LN APT 223",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761377089",
"telephone_number": "915-215-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 S BUCKNER BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752272373",
"telephone_number": "214-381-7700",
"fax_number": "972-707-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "KRISTIAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-28",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1337573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.