Individual provider Active NPI

Steven Vyacheslav Gutin, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1255370276
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021863 Issued in NY
Practice address
726 Ave Z
Brooklyn, NY 11223
Phone
(718) 872-7373
NPI assigned
Jun 5, 2006
Last updated
Feb 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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 021863 NY Primary

Addresses

Primary practice location

726 Ave Z
Brooklyn, NY 11223

Mailing address

1711 Sheepshead Bay Road
Apt 5a
Brooklyn, NY 11235
Phone (347) 922-4349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721001473 NY Practitioner - Physical Therapist in Private Practice 4284614173 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Be Well Primary Health Care Center LLCGroup PAC ID 2062305030, 44 clinicians
Bay Park One Medical, PCGroup PAC ID 0749206209, 5 clinicians

Practice addresses (Care Compare)

2334 E 28TH St
Brooklyn, NY 11229-5034
Phone (347) 922-4349

3007 Farragut Rd
Brooklyn, NY 11210-1537
Phone (718) 434-0711

6401 18TH Ave
Brooklyn, NY 11204-3788
Phone (347) 922-4349

6407 18TH Ave
Brooklyn, NY 11204-3730
Phone (718) 621-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Park One Medical, PC CurrentSince Sep 1, 2007 Accepting new patients
A2Z Physical Therapy PC Physical Therapist Current Accepting new patients
Mermaid Operating Co, LLC Physical Therapist PastSince Nov 4, 2005 Accepting new patients
Little Achievers Ei, LLC PastSince Aug 30, 2020 Accepting new patients
Anarafena Medical, PLLC Past Accepting new patients

Locations

9229 Queens Blvd
Ste 2C
Rego Park, NY 11374
Phone (718) 459-1931

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1255370276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 SHEEPSHEAD BAY ROAD",
            "address_2": "APT 5A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "347-922-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 AVE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "718-872-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIN",
        "first_name": "STEVEN",
        "middle_name": "VYACHESLAV",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.