Individual provider Active NPI

Ian Gabriel

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1154182269
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-033412 Issued in AZ
Practice address
5410 N Scottsdale Rd
Phoenix, AZ 85016-8501
Phone
(600) 795-6865
NPI assigned
Jan 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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 LPT-033412 AZ Primary

Addresses

Primary practice location

5410 N Scottsdale Rd
Phoenix, AZ 85016-8501

Mailing address

1003 N Parkside Drive
Tempe, AZ 85281

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219000896 AZ Practitioner - Physical Therapist in Private Practice 4981048907 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)

5410 N Scottsdale Rd
Suite A100
Paradise Valley, AZ 85253-5956
Phone (480) 609-0822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-033412AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist Current Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Jan 15, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Jan 15, 2024 Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

5410 N Scottsdale Rd
Ste A100
Scottsdale, AZ 85253
Phone (480) 609-0822

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1154182269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N PARKSIDE DRIVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 N SCOTTSDALE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168501",
            "telephone_number": "600-795-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.