Individual provider Active NPI

Gianna L Pociask, DPT

  • Physical Therapist
  • Goshen, IN
National Provider Identifier
1366159782
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0501187A Issued in IN
Practice address
2222 Rieth Blvd
Goshen, IN 46526-5868
Phone
(574) 875-1200
NPI assigned
Nov 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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 0501187A IN Primary

Addresses

Primary practice location

2222 Rieth Blvd
Goshen, IN 46526-5868

Mailing address

3245 Health Drive
Suite 100
Granger, IN 46530-4239
Phone (574) 647-1840

Other practice location 1

1815 E Ireland Road,
Ste 100
South Bend, IN 46614-2845
Phone (574) 647-5790

Other practice location 2

900 I Street,
Ste 100
La Porte, IN 46350-5533
Phone (219) 324-1730

Other practice location 3

200 E Jackson Blvd
Ste 150
Elkhart, IN 46516-3513
Phone (574) 389-5558

Other practice location 4

3221 Beacon Parkway,
Ste 100
Granger, IN 46530-7196
Phone (574) 647-2930

Other identifiers 1

IdentifierTypeStateIssuer
300070190MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217002707 IN Practitioner - Physical Therapist in Private Practice 7113399270 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0501187AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health, LLC Physical Therapist CurrentSince Dec 15, 2022 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients
Beacon Health, LLC Past Accepting new patients

Locations

200 E Jackson Blvd
Ste 150
Elkhart, IN 46516
Phone (574) 389-5558

2222 Rieth Blvd
Ste 103
Goshen, IN 46526
Phone (574) 875-9616

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

3221 Beacon Pkwy
Ste 100
Granger, IN 46530
Phone (574) 647-2930

900 I St
#100
Laporte, IN 46350
Phone (219) 324-1730

1815 E Ireland Rd
#100
South Bend, IN 46614
Phone (574) 647-5790

Organizations & group practices 3

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": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1366159782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DRIVE",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304239",
            "telephone_number": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 RIETH BLVD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265868",
            "telephone_number": "574-875-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 E Ireland Road,",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-5790",
            "fax_number": "574-647-5792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I Street,",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "La Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1730",
            "fax_number": "219-324-1735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Jackson Blvd",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465163513",
            "country_code": "US",
            "telephone_number": "574-389-5558",
            "fax_number": "574-389-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3221 Beacon Parkway,",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465307196",
            "country_code": "US",
            "telephone_number": "574-647-2930",
            "fax_number": "574-647-2935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POCIASK",
        "first_name": "GIANNA",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "0501187A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300070190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.