Active NPI
Gary David Webskowski, MPT
- Orthopedic Physical Therapist
- Bloomington, MN
National Provider Identifier
1164491908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 6090
- Practice address
- 8100 Northland Dr
Bloomington, MN 55431-4800 - Phone
- (952) 806-5619
- Fax
- (952) 806-5510
- NPI assigned
- Mar 15, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 6090 | MN | Primary |
Addresses
Primary practice location
8100 Northland Dr
Bloomington, MN 55431-4800
Mailing address
8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 806-5619
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059G6WE | Other | BCBS | |
| 104667 | Other | UCARE | |
| 6090 | Other | MN STATE LICENSE | |
| 6576528 | Other | AOA ST TAX | |
| 989211040352 | Other | PREFERRED ONE | |
| HP40440 | Other | HEALTH PARTNERS | |
| 411239729 | Other | FEDERAL TAX | |
| 30701054 | Other | PRIMWEST BILLING | |
| 6404578 | Other | MEDICA | |
| 138399200 | Other | ACS PROV | |
| P00082826 | Other | TRAVELERS MEDICARE |
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 |
|---|---|---|---|
| 6090 | MN | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1164491908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 NORTHLAND DR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314800",
"telephone_number": "952-806-5619",
"fax_number": "952-806-5510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 NORTHLAND DR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314800",
"telephone_number": "952-806-5619",
"fax_number": "952-806-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBSKOWSKI",
"first_name": "GARY",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MN",
"license": "6090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "059G6WE",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "104667",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN STATE LICENSE",
"identifier": "6090",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AOA ST TAX",
"identifier": "6576528",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "989211040352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP40440",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX",
"identifier": "411239729",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIMWEST BILLING",
"identifier": "30701054",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6404578",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS PROV",
"identifier": "138399200",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS MEDICARE",
"identifier": "P00082826",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.