Individual provider Active NPI

Rogelio Rivera Jr., PT, PHD, DPT, MCHES

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1720162217
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1166310 Issued in TX
Practice address
734 North Loop
Houston, TX 77009-1043
Phone
(713) 868-2766
Fax
(713) 868-7575
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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 1166310 TX Primary

Addresses

Primary practice location

734 North Loop
Houston, TX 77009-1043

Mailing address

734 North Loop
Houston, TX 77009-1043
Phone (713) 868-2766

Other practice location 1

12573 Broadway St Ste 151
Pearland, TX 77584-8973
Phone (832) 243-6294

Other names 1

  • Dr. Roy Rivera Jr. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150106002417 TX Practitioner - Physical Therapist in Private Practice 2264755818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Crom Rehabilitation, LLCGroup PAC ID 3375866924, 3 clinicians

Practice addresses (Care Compare)

12573 Broadway St
Suite 151
Pearland, TX 77584-8973
Phone (832) 243-5055

734 N Loop
Houston, TX 77009-1043
Phone (713) 868-2766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1166310TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crom Rehabilitation, LLC Physical Therapist CurrentSince Nov 1, 2014 Accepting new patients
Complete Range of Motion, LLC Physical Therapist Current Accepting new patients

Locations

946 N Shepherd Dr
Ste A
Houston, TX 77008
Phone (713) 868-2766

734 North Loop
Houston, TX 77009
Phone (713) 866-2766

12573 Broadway St
Ste 151
Pearland, TX 77584
Phone (713) 868-2766

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1720162217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 NORTH LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770091043",
            "telephone_number": "713-868-2766",
            "fax_number": "713-868-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 NORTH LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770091043",
            "telephone_number": "713-868-2766",
            "fax_number": "713-868-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12573 Broadway St Ste 151",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775848973",
            "country_code": "US",
            "telephone_number": "832-243-6294",
            "fax_number": "832-243-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ROGELIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, PHD, DPT, MCHES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1166310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROY",
            "last_name": "RIVERA",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "PT, PHD, DPT, MCHES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.

Verify at the official NPI Registry.