Individual provider Active NPI

Thomas Gosal, DPT

  • Physical Therapist
  • San Dimas, CA
National Provider Identifier
1104519826
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT304044 Issued in CA
Practice address
630 W Arrow Hwy
San Dimas, CA 91773-2969
Phone
(909) 592-2778
Fax
(909) 592-2789
NPI assigned
May 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 PT304044 CA Primary

Addresses

Primary practice location

630 W Arrow Hwy
San Dimas, CA 91773-2969

Mailing address

630 W Arrow Hwy
San Dimas, CA 91773-2969
Phone (909) 592-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914001737 CA Practitioner - Physical Therapist in Private Practice 0547624173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Rehab Physical Therapy PCGroup PAC ID 7012254774, 3 clinicians

Practice addresses (Care Compare)

630 W Arrow Hwy
San Dimas, CA 91773-2969
Phone (909) 592-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT304044CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Rehab Physical Therapy PC Physical Therapist CurrentSince Jul 16, 2023 Accepting new patients

Locations

630 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 592-2778

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1104519826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W ARROW HWY",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732969",
            "telephone_number": "909-592-2778",
            "fax_number": "909-592-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W ARROW HWY",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732969",
            "telephone_number": "909-592-2778",
            "fax_number": "909-592-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSAL",
        "first_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.