Individual provider Active NPI

Cristina Acevez-Rivera, COTA/L

  • Occupational Therapy Assistant
  • Mesa, AZ
National Provider Identifier
1912570730
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-047185 Issued in AZ
Practice address
2150 S Country Club Dr Ste 20
Mesa, AZ 85210-6879
Phone
(480) 398-4280
NPI assigned
Jul 20, 2021
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA5580 CA
Occupational Therapy Assistant 224Z00000X OTA-047185 AZ Primary

Addresses

Primary practice location

2150 S Country Club Dr Ste 20
Mesa, AZ 85210-6879

Mailing address

4710 W Lucky Way
Santa Ana, CA 92704-1138

Other practice location 1

21515 Hawthorne Blvd Ste Gl-100
Torrance, CA 90503-6501
Phone (424) 571-2618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA-047185AZMDOccupational Therapy Assistant
OTA5580CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piller Child Development PastSince Apr 9, 2023 Accepting new patients
Piller Child Development LLC PastSince Apr 9, 2023 Accepting new patients
Cortica Behavioral Health Inc PastSince Jul 1, 2021 Accepting new patients
Cortica Healthcare Inc PastSince Jul 1, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1912570730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 W LUCKY WAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927041138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 S COUNTRY CLUB DR STE 20",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106879",
            "telephone_number": "480-398-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21515 Hawthorne Blvd Ste Gl-100",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905036501",
            "country_code": "US",
            "telephone_number": "424-571-2618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEZ-RIVERA",
        "first_name": "CRISTINA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA5580",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-047185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.