Active NPI
Gabriel D Ettenson, PT
- Physical Therapist
- Niwot, CO
National Provider Identifier
1154323624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0012163
- Practice address
- 210 Franklin St
Niwot, CO 80544-5013 - Phone
- (516) 967-8108
- Fax
- (516) 967-8108
- NPI assigned
- Aug 13, 2005
- Last updated
- Jul 11, 2026
- 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 | 0012163 | CO | Primary |
Addresses
Primary practice location
210 Franklin St
Niwot, CO 80544-5013
Mailing address
5624 Cottontail Dr
Longmont, CO 80503-9529
Phone (516) 967-8108
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 |
|---|---|---|---|
| 018764 | NY | MD | Clinical Psychologist |
| 018762 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D E Delopoulos | Physical Therapist | Current | Accepting new patients |
Locations
261 E 78th St
Fl 2
New York, NY 10075
Phone (212) 472-5820
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.
-
dba Hand Therapy and Ergonomics
- Hand Occupational Therapist
- Long Branch, NJ
- NPI 1477958411
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783728000000",
"number": "1154323624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5624 COTTONTAIL DR",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805039529",
"telephone_number": "516-967-8108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 FRANKLIN ST",
"city": "NIWOT",
"state": "CO",
"postal_code": "805445013",
"telephone_number": "516-967-8108",
"fax_number": "516-967-8108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETTENSON",
"first_name": "GABRIEL",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-13",
"last_updated": "2026-07-11",
"certification_date": "2026-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0012163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Niwot, CO
- Margaret Alise Curry, M.D.
- Helen Domaratz Ting, LMT
- Dr. Michelle C Winston
- Elanvital Creative Journeys Counseling
- Linda Engelbrecht
- Ferrington Physical Therapy, LLC (Ability Physical Therapy)
- Candice Finn
- Kristin M. Foreman, MS, RD
- Michael Phillip Garza, PMHNP-BC
- Catherine McLeod Gatley, L.AC. M.AC. DIPL.AC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.