Individual provider Active NPI

John Rivas, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1770976003
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033599-1 Issued in NY
Practice address
1379 54TH St
Brooklyn, NY 11219-4259
Phone
(718) 853-8503
Fax
(718) 853-8498
NPI assigned
Mar 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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 033599-1 NY Primary

Addresses

Primary practice location

1379 54TH St
Brooklyn, NY 11219-4259

Mailing address

1379 54TH St
Brooklyn, NY 11219-4259
Phone (718) 853-8503

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171101000015 NY Practitioner - Physical Therapist in Private Practice 3476829714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

158 Broadway
Brooklyn, NY 11211-8766
Phone (718) 963-0882

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033599-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 15, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Apr 15, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

27 Smith St
Fl 3
Brooklyn, NY 11201
Phone (718) 488-0001

27 Smith St
Fl 5
Brooklyn, NY 11201
Phone (718) 488-0001

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1770976003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194259",
            "telephone_number": "718-853-8503",
            "fax_number": "718-853-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194259",
            "telephone_number": "718-853-8503",
            "fax_number": "718-853-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033599-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.