Individual provider Active NPI

Robert Lee Gustitus, DPT

  • Orthopedic Physical Therapist
  • Wixom, MI
National Provider Identifier
1104595321
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501020234
Practice address
50200 Dennis CT
Wixom, MI 48393-2021
Phone
(248) 229-5000
NPI assigned
Sep 10, 2021
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 5501020234 Primary

Addresses

Primary practice location

50200 Dennis CT
Wixom, MI 48393-2021

Mailing address

50200 Dennis CT
Wixom, MI 48393-2021
Phone (248) 229-5000

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

Practice roles

OrganizationSpecialtyStatusNew patients
Element Chiropractic & Wellness, LLC CurrentSince Sep 12, 2021 Accepting new patients

Locations

50200 Dennis Ct
Wixom, MI 48393
Phone (248) 229-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1104595321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50200 DENNIS CT",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483932021",
            "telephone_number": "248-229-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50200 DENNIS CT",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483932021",
            "telephone_number": "248-229-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTITUS",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": "5501020234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wixom, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.