Active NPI
Stanley Gusman, PT
- Physical Therapist
- Boca Raton, FL
National Provider Identifier
1124051149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 3326
- Practice address
- 9060 Kimberly Blvd
#44
Boca Raton, FL 33434-2842 - Phone
- (561) 482-7474
- Fax
- (561) 482-3791
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 3326 | FL | Primary |
Addresses
Primary practice location
9060 Kimberly Blvd
#44
Boca Raton, FL 33434-2842
Mailing address
15 Apex Dr
Highland, IL 62249-1282
Phone (618) 651-0444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y2297 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 3326 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1124051149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 APEX DR",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622491282",
"telephone_number": "618-651-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9060 KIMBERLY BLVD",
"address_2": "#44",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334342842",
"telephone_number": "561-482-7474",
"fax_number": "561-482-3791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSMAN",
"first_name": "STANLEY",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 3326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Y2297",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.