Jeffrey W Gardner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8576 Issued in AZ

Practice address

4850 E Baseline Rd
Suite 114
Mesa, AZ 85206-4625

Phone

(480) 396-2781

Fax

(480) 854-3094

NPI assigned

Sep 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Physical Therapy LLCGroup PAC ID 4486886785, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gateway Physical Therapy LLC

  • Physical Therapist
  • Mesa, AZ
  • NPI 1346677242
  Medicare reassignment Care Compare group
• Arenson Wasserbeck LLC

  • Physical Therapist
  • Mesa, AZ
  • NPI 1316946379
  Medicare reassignment NPD
• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment NPD
• VMD Primary Providers of Arizona

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1689236135
  NPD
• Aw Broadway and Craycroft, LLC

  • Physical Therapist
  • Tucson, AZ
  • NPI 1588386494
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1366775835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 E BASELINE RD",
            "address_2": "SUITE 114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064625",
            "telephone_number": "480-396-2781",
            "fax_number": "480-854-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 E BASELINE RD",
            "address_2": "SUITE 114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064625",
            "telephone_number": "480-396-2781",
            "fax_number": "480-854-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465630",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Satya S Garcia, LMSW
• Sergio Garcia
• Sylvia Garcia, M.A., LISAC
• Beau Gardner, PMHNP
• Dayton Gardner
• Kisha M. Gardner, SLPA
• Mara Gardner
• Monce Gardner
• Quinton Wayne Gardner, DMD
• Shaun Patrick Gardner, DDS

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.