Individual provider Active NPI

David Anthony Crivello, DPT

  • Physical Therapist
  • Brentwood, CA
National Provider Identifier
1972848398
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39587 Issued in CA
Practice address
1384 Springdale CT
Brentwood, CA 94513-2397
Phone
(925) 565-7999
NPI assigned
Dec 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 39587 CA Primary

Addresses

Primary practice location

1384 Springdale CT
Brentwood, CA 94513-2397

Mailing address

1384 Springdale CT
Brentwood, CA 94513-2397
Phone (925) 565-7999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000160 CA Practitioner - Physical Therapist in Private Practice 9830343862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39587CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kabat and Associates Physical Therapy Physical Therapist CurrentSince Nov 1, 2012 Accepting new patients
Purpose Physical Therapy, PC CurrentSince Jan 17, 2021 Accepting new patients
Sutter East Bay Medical Foundation PastSince Nov 1, 2012 Accepting new patients

Locations

5161 Lone Tree Way
Antioch, CA 94531
Phone (925) 522-8000

Organizations & group practices 3

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": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1972848398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1384 SPRINGDALE CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132397",
            "telephone_number": "925-565-7999",
            "fax_number": "925-522-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 SPRINGDALE CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132397",
            "telephone_number": "925-565-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIVELLO",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.