Individual provider Active NPI

Michael M. Gus, PT

  • Orthopedic Physical Therapist
  • Yorkville, NY
National Provider Identifier
1093928400
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
022174-1 Issued in NY
Practice address
5094 Commercial Dr
Yorkville, NY 13495-1106
Phone
(315) 768-8521
Fax
(315) 768-7882
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 022174-1 NY Primary

Addresses

Primary practice location

5094 Commercial Dr
Yorkville, NY 13495-1106

Mailing address

3061 State Route 28
Herkimer, NY 13350-1041
Phone (315) 717-0020

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
022174NYMDClinical Psychologist
022174-1NYMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1093928400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 STATE ROUTE 28",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501041",
            "telephone_number": "315-717-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5094 COMMERCIAL DR",
            "city": "YORKVILLE",
            "state": "NY",
            "postal_code": "134951106",
            "telephone_number": "315-768-8521",
            "fax_number": "315-768-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUS",
        "first_name": "MICHAEL",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "022174-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.