Individual provider Active NPI

Andrew Gushen, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1063954543
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039833 Issued in NY
Practice address
1221 Avenue of Americas
At New York Sports Club
New York, NY 10020-1001
Phone
(646) 562-0617
Fax
(914) 315-1799
NPI assigned
Nov 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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 039833 NY Primary

Addresses

Primary practice location

1221 Avenue of Americas
At New York Sports Club
New York, NY 10020-1001

Mailing address

1221 Avenue of Americas
At New York Sports Club
New York, NY 10020
Phone (646) 562-0617

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
039833NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1063954543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 AVENUE OF AMERICAS",
            "address_2": "AT NEW YORK SPORTS CLUB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10020",
            "telephone_number": "646-562-0617",
            "fax_number": "914-315-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 AVENUE OF AMERICAS",
            "address_2": "AT NEW YORK SPORTS CLUB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201001",
            "telephone_number": "646-562-0617",
            "fax_number": "914-315-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSHEN",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.