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MS. JENNIFER L VIVANCO RPT
NPI 1982767596
Specialist in Porter Ranch, CA

Active since December 18, 2006Accepts Medicare Assignment
11239 TAMPA AVE STE 205, PORTER RANCH, CA 91326(818) 831-0484(818) 832-9389 Get Directions Write a Review

NPPES record last updated: February 24, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Jennifer L Vivanco Rpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JENNIFER L VIVANCO RPT (NPI 1982767596) is an individual specialist in Porter Ranch, California, licensed in California (PT20306) and active in the NPI registry since December 2006. She is a graduate of Other (1979).

NPPES Registry Identity

NPI1982767596
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameMS. JENNIFER L VIVANCOCredential: RPT
Location Address11239 TAMPA AVE STE 205Porter Ranch, CA 91326-3782
Mailing Address11239 Tampa Ave Ste 205Porter Ranch, CA 91326-3782 · (818) 831-0484 · Fax (818) 832-9389
Phone(818) 831-0484
Fax(818) 832-9389
Sole ProprietorYes
Medical School CMSOtherGraduated 1979
Enumeration DateDecember 18, 2006
Last NPPES UpdateFebruary 24, 2020
✔ NPI 1982767596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · PT20306
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
11239 TAMPA AVE STE 205, Porter Ranch, CA 91326
Open in Google Maps ↗

Other Identifiers 1

MedicaidPT0203060CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Jennifer L Vivanco Rpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42267155
PECOS Enrollment IDI20050331001003

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Vivanco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Spine And Body Wellness
7.4 mi
Physical Medicine & Rehabilitation
20501 VENTURA BLVD STE 252
Woodland Hills, CA 91364
  • Reassigned Medicare billing, California enrollment
  • 3 clinicians in this Medicare group
NPI 1982481172 (818) 350-7265

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRIORITY PHYSICAL THERAPY INC
Specialist
11239 TAMPA AVE STE 205
PORTER RANCH, CA 91326
Los Angeles County (818) 831-0484

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Vivanco's NPI number?

The NPI number for Jennifer Vivanco is 1982767596. It was assigned to this individual provider in the NPPES registry on December 18, 2006.

Where is Jennifer Vivanco located?

Jennifer Vivanco practices at 11239 Tampa Ave Ste 205, Porter Ranch, CA 91326. The listed phone number is (818) 831-0484.

What is Jennifer Vivanco's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Jennifer Vivanco enrolled in Medicare?

Yes. Jennifer Vivanco is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jennifer Vivanco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Vivanco reassigns Medicare benefits to Spine And Body Wellness (Woodland Hills, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Vivanco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Vivanco was last updated on February 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.