Individual provider Active NPI

Evangelina Rivera, OTR

  • Occupational Therapist
  • Tampa, FL
National Provider Identifier
1881362010
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
22291 Issued in FL
Practice address
15002 Hutchison Rd
Tampa, FL 33625-5502
Phone
(813) 960-1969
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 22291 FL Primary

Addresses

Primary practice location

15002 Hutchison Rd
Tampa, FL 33625-5502

Mailing address

245 SE 2ND Ave
South Bay, FL 33493-2324
Phone (321) 440-0164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031001903 NC Practitioner - Occupational Therapist in Private Practice 8325571169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

507 Wakefield Dr
Apt C
Charlotte, NC 28209-3148
Phone (704) 285-8207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22291FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT NC LLC Occupational Therapist CurrentSince Aug 1, 2024 Accepting new patients
Collective Therapy Corp. Occupational Therapist CurrentSince Feb 16, 2026 Accepting new patients

Locations

8919 Park Rd
Charlotte, NC 28210
Phone (704) 384-1225

2008 Moore Rd
Matthews, NC 28105

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1881362010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 SE 2ND AVE",
            "city": "SOUTH BAY",
            "state": "FL",
            "postal_code": "334932324",
            "telephone_number": "321-440-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15002 HUTCHISON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336255502",
            "telephone_number": "813-960-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EVANGELINA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "22291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.