Individual provider Active NPI

G Michael Gublo, CPO

  • Prosthetist
  • Rochester, NY
National Provider Identifier
1083871669
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
1401 Stone Rd
Suite 201B
Rochester, NY 14615-1537
Phone
(585) 663-5860
Fax
(585) 368-9274
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X
Prosthetist 224P00000X Primary

Addresses

Primary practice location

1401 Stone Rd
Suite 201B
Rochester, NY 14615-1537

Mailing address

42 Morning Glory LN
Rochester, NY 14626-4729
Phone (585) 663-5860

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
Advanced Prosthetic Design LLC Orthotist Current Accepting new patients

Locations

1401 Stone Rd
Ste 201B
Rochester, NY 14615
Phone (585) 663-5860

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1083871669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MORNING GLORY LN",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264729",
            "telephone_number": "585-663-5860",
            "fax_number": "585-368-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 STONE RD",
            "address_2": "SUITE 201B",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146151537",
            "telephone_number": "585-663-5860",
            "fax_number": "585-368-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBLO",
        "first_name": "G MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.