Individual provider Active NPI

Gerwyn Erick Pimentel Dael, PT

  • Physical Therapist
  • Fort Lauderdale, FL
National Provider Identifier
1003098443
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440
Phone
(954) 332-4446
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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 Primary

Addresses

Primary practice location

3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440

Mailing address

3290 N Ridge Rd
Suite 290
Ellicott City, MD 21043-3655
Phone (410) 750-9006

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medpro Physical Therapist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22081/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1003098443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD",
            "address_2": "SUITE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433655",
            "telephone_number": "410-750-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W COMMERCIAL BLVD",
            "address_2": "SUITE 116",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093440",
            "telephone_number": "954-332-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAEL",
        "first_name": "GERWYN ERICK",
        "middle_name": "PIMENTEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.