Individual provider Active NPI

Gerald Caporado Pascual

  • Physical Therapist
  • Macon, GA
National Provider Identifier
1285962126
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1800 Wesleyan Dr Apt 198
Macon, GA 31210-1088
Phone
(478) 284-8279
NPI assigned
Dec 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 009443 GA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1800 Wesleyan Dr Apt 198
Macon, GA 31210-1088

Mailing address

1800 Wesleyan Dr Apt 198
Macon, GA 31210-1088
Phone (478) 284-8279

Other practice location 1

5980 W 71st St Ste 102
Indianapolis, IN 46278-1785
Phone (317) 388-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703002881 GA Practitioner - Physical Therapist in Private Practice 5193239994 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009443GAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Therapy Services, Inc. Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Access Therapies,Inc Past Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

Organizations & group practices 2

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": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1285962126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WESLEYAN DR APT 198",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101088",
            "telephone_number": "478-284-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESLEYAN DR APT 198",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101088",
            "telephone_number": "478-284-8279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5980 W 71st St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462781785",
            "country_code": "US",
            "telephone_number": "317-388-0800",
            "fax_number": "317-388-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "GERALD",
        "middle_name": "CAPORADO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-04",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": "009443",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.