Gino D'Agostino, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501303150 Issued in MI

Practice address

20059 King Rd
Woodhaven, MI 48183-1032

Phone

(734) 365-5112

Fax

(734) 365-5115

NPI assigned

Dec 28, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gino.dagostino.p4@direct.athleticoltd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  MI

  Medicare reassignment Care Compare group NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Bloomfield Hills, MI
  • NPI 1548932619
  Medicare reassignment NPD
• Athletico LTD

  dba Athletico Physical Therapy

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Marietta, GA
  • NPI 1508538158
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1033988340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20059 KING RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831032",
            "telephone_number": "734-365-5112",
            "fax_number": "734-365-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "GINO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Clark, FNP
• Comp RX Inc
• Amy Marie Conner, CPHT
• Miranda Cunningham, RN
• D & S Pharmacy LLC (D and S Pharmacy)
• Alyssa Daugherty
• Nicholas Davidson, D.D.S
• Dental House - Downriver
• Valerie Leigh Desmond, RPH
• Dexter K Flemming DDS Ms PC (Michigan Center for Oral Surgery)

• Physical Therapist in Woodhaven, MI
• Providers in Woodhaven, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.