Active NPI
Michael Gingolaski, OTR/L
- Occupational Therapist
- Oxford, CT
National Provider Identifier
1396280749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002646
- Practice address
- 4 Split Rail CT
Oxford, CT 06478-3206 - Phone
- (203) 906-5010
- NPI assigned
- Dec 21, 2016
- Last updated
- Dec 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 002646 | CT | Primary |
Addresses
Primary practice location
4 Split Rail CT
Oxford, CT 06478-3206
Mailing address
4 Split Rail CT
Oxford, CT 06478-3206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002646 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482278400000",
"number": "1396280749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SPLIT RAIL CT",
"city": "OXFORD",
"state": "CT",
"postal_code": "064783206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SPLIT RAIL CT",
"city": "OXFORD",
"state": "CT",
"postal_code": "064783206",
"telephone_number": "203-906-5010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GINGOLASKI",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-21",
"last_updated": "2016-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "002646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.