Individual provider Active NPI

Ilya Gluskin, PT

  • Physical Therapist
  • Malden, MA
National Provider Identifier
1265862254
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20578 Issued in MA
Practice address
350 Main St
Malden, MA 02148-5089
Phone
(781) 321-2727
Fax
(781) 321-4995
NPI assigned
Nov 12, 2013
Last updated
Nov 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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 20578 MA Primary

Addresses

Primary practice location

350 Main St
Malden, MA 02148-5089

Mailing address

350 Main St
Malden, MA 02148-5089
Phone (781) 321-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925000851 MA Practitioner - Physical Therapist in Private Practice 2769614544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Medical and Physical Therapy Associates IncGroup PAC ID 3779525837, 23 clinicians

Practice addresses (Care Compare)

2 Washington St
Melrose, MA 02176-6055
Phone (781) 321-7000

500 W Cummings Park
Woburn, MA 01801-6513
Phone (781) 305-4656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Medical & Physical Therapy Associates Inc. Physical Therapist CurrentSince Sep 1, 2015 Accepting new patients
McGovern Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Dr Jennifer S Wu PC Past Accepting new patients
Byron V Hartunian MD PC Past Accepting new patients

Locations

500 W Cummings Park
Ste 21
Woburn, MA 01801
Phone (781) 305-4656

500 W Cummings Park
Ste 2100
Woburn, MA 01801
Phone (781) 305-4656

Organizations & group practices 4

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": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1265862254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485089",
            "telephone_number": "781-321-2727",
            "fax_number": "781-321-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485089",
            "telephone_number": "781-321-2727",
            "fax_number": "781-321-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUSKIN",
        "first_name": "ILYA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.