Individual provider Active NPI

Boris Gigov, PT, DPT

  • Physical Therapist
  • Hales Corners, WI
National Provider Identifier
1124703053
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16405-24 Issued in WI
Practice address
5700 S 108TH St
Hales Corners, WI 53130-1911
Phone
(800) 974-4378
Fax
(630) 515-1536
NPI assigned
Jun 19, 2023
Last updated
Jun 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 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 16405-24 WI Primary

Addresses

Primary practice location

5700 S 108TH St
Hales Corners, WI 53130-1911

Mailing address

24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378

Other names 1

  • Bobby Gigov Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009002481 WI Practitioner - Physical Therapist in Private Practice 9739534983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5700 S 108TH St
Hales Corners, WI 53130-1911
Phone (414) 567-3022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16405-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopedic Specialty Hospital, LLC Current Accepting new patients
Midwest Orthopedic Specialty Hospital, LLC CurrentSince Sep 25, 2023 Accepting new patients
Midwest Orthopedic Specialty Hospital, LLC CurrentSince Sep 25, 2023 Accepting new patients

Locations

7095 S Ballpark Dr
Unit 100
Franklin, WI 53132
Phone (414) 817-6620

5700 S 108th St
Hales Corners, WI 53130
Phone (414) 239-9448

Organizations & group practices 3

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1124703053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD UNIT 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301911",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIGOV",
        "first_name": "BORIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16405-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBY",
            "last_name": "GIGOV",
            "credential": "PT, DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.