Individual provider Active NPI

Gustavo Alejandro Rivera David, DPT

  • Physical Therapist
  • Belleville, IL
National Provider Identifier
1962306092
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070041217 Issued in IL
Practice address
2346 Mascoutah Ave
Belleville, IL 62220-3499
Phone
(618) 277-6282
NPI assigned
Oct 3, 2026
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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 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.

Verify at the official NPI Registry.