Ishmael Gibson

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

815 Hutchinson River Pkwy
Bronx, NY 10465-1887

Phone

(718) 684-4433

Fax

(718) 684-4434

NPI assigned

Jun 10, 2022

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Rockville Centre, NY
  • NPI 1205296902

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Achieve at Home Physical Therapy PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1932840188
  Medicare reassignment NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Whitestone, NY
  • NPI 1487104261

  Physical Therapist

  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680

  Physical Therapist

  NPD

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1053040345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HUTCHINSON RIVER PKWY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651887",
            "telephone_number": "718-684-4433",
            "fax_number": "718-684-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ISHMAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla M Giboyeaux, NUTRITIONIST
• Eileen L Gibson-Green, O.T.R./L
• Andi Gibson
• Delfia Denise Gibson, RN
• Diala Gibson, DDS
• Laura Gibson, REGISTERED NURSE
• Michael William Gibson, MA, LMHC
• Sasshine Imani Gibson, B.A. ED
• Chantal San Miguel Gicquel, M.D.
• Lori Ann Gics-Scerbo, OD

• Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.