Ailene Bundalian Rivera, RPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT28631 Issued in CA

Practice address

1711 W Temple St # 2056
Los Angeles, CA 90026-5421

Phone

(818) 634-6328

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• California Rehab Group

  • Geriatric Physical Therapist
  • North Hollywood, CA
  • NPI 1376566711

  Geriatrics

  NPD (past) Authorized official
• Care Plus Medical Group, Inc.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1336259118
  NPD
• Lighthouse HHC

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1841896974
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1740212356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11024 BALBOA BLVD",
            "address_2": "504",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445007",
            "telephone_number": "818-634-6328",
            "fax_number": "818-785-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 W TEMPLE ST # 2056",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900265421",
            "telephone_number": "818-634-6328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18546 Roscoe Blvd",
            "address_2": "307",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913244663",
            "country_code": "US",
            "telephone_number": "818-634-6328",
            "fax_number": "818-785-9332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "AILENE",
        "middle_name": "BUNDALIAN",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "PT28631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Refugio Rivera-Estrada
• Patricia Maria Rivera-Garcia
• Berta Alicia Rivera-Martinez
• Carolina Rivera-Martinez
• Sonya Emilia Rivera-Simental, L.M.F.T.
• Alejandro Rivera
• Alexa Rivera
• Aliza Monica Rivera
• Amparo Rivera
• Andrea Rivera

• Geriatric Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.