Individual provider Active NPI

Gary N McEwen II, PT

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1023445129
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31177 Issued in AZ
Practice address
14601 N Scottsdale Rd Ste 108
Scottsdale, AZ 85254-2984
Phone
(480) 729-8400
Fax
(480) 651-8102
NPI assigned
Oct 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1560 ID
Physical Therapist 225100000X LPT-31177 AZ Primary

Addresses

Primary practice location

14601 N Scottsdale Rd Ste 108
Scottsdale, AZ 85254-2984

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 928-5080

Other practice location 1

701 Lewiston Street
Cottonwood, ID 83522-0137
Phone (208) 962-3251 ext. 4455

Other practice location 2

7919 E Thomas Rd Ste 114
Scottsdale, AZ 85251-6540
Phone (480) 729-8316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220315002617 ID Practitioner - Physical Therapist in Private Practice 9133557267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Canyon Medical Center IncGroup PAC ID 0941371439, 73 clinicians

Practice addresses (Care Compare)

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-1560IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center, Inc. CurrentSince Oct 15, 2024 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Oct 15, 2024 Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
Peak Physical Therapy P C Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Institute of Physical Therapy and Fitness Physical Therapist Past Accepting new patients
Inland Cardiology Associates, P.S. Past Accepting new patients
McCall Physical Therapy, P.a. Physical Therapist Past Accepting new patients

Locations

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

678 Southway Ave
Lewiston, ID 83501
Phone (208) 746-1418

Interoperability endpoints

  • Direct secure messaging: gary.mcewenii.p6@direct.athleticoltd.nextgenshare.com

Organizations & group practices 7

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1023445129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-928-5080",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 N SCOTTSDALE RD STE 108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542984",
            "telephone_number": "480-729-8400",
            "fax_number": "480-651-8102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Lewiston Street",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "ID",
            "postal_code": "835220137",
            "country_code": "US",
            "telephone_number": "208-962-3251 x4455",
            "fax_number": "208-962-3722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7919 E Thomas Rd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516540",
            "country_code": "US",
            "telephone_number": "480-729-8316",
            "fax_number": "480-542-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "GARY",
        "middle_name": "N",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-03",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1560",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.