Active NPI
Gustavo Alejandro Rivera David, DPT
- Physical Therapist
- Belleville, IL
National Provider Identifier
1962306092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070041217
- Practice address
- 2346 Mascoutah Ave
Belleville, IL 62220-3499 - Phone
- (618) 277-6282
- NPI assigned
- Oct 3, 2026
- Last updated
- Oct 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070041217 | IL | Primary |
Addresses
Primary practice location
2346 Mascoutah Ave
Belleville, IL 62220-3499
Mailing address
PO Box 2492
Coamo, PR 00769-4492
Phone (787) 988-1761
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790985600000",
"number": "1962306092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2492",
"city": "COAMO",
"state": "PR",
"postal_code": "007694492",
"telephone_number": "787-988-1761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2346 MASCOUTAH AVE",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622203499",
"telephone_number": "618-277-6282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA DAVID",
"first_name": "GUSTAVO",
"middle_name": "ALEJANDRO",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-03",
"last_updated": "2026-10-03",
"certification_date": "2026-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070041217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.