Active NPI
Andrew Gomo, PT, DPT
- Physical Therapist
- Highland, NY
National Provider Identifier
1396579595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 052697
- Practice address
- 3598 Route 9W Ste a
Highland, NY 12528-1753 - Phone
- (845) 709-8977
- Fax
- (845) 406-4928
- NPI assigned
- Aug 29, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 052697 | NY | Primary |
Addresses
Primary practice location
3598 Route 9W Ste a
Highland, NY 12528-1753
Mailing address
3598 Route 9W Ste a
Highland, NY 12528-1753
Phone (845) 709-8977
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
670 6TH Ave
Brooklyn, NY 11215-6800
Phone (718) 230-1180
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052697 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC | Current | Accepting new patients |
Locations
550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737
3598 Route 9W
Ste A
Highland, NY 12528
Phone (845) 709-8977
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.
-
- Physical Therapist
- Harrison, NY
- NPI 1396799409
-
- Physical Therapist
- Brooklyn, NY
- NPI 1356703631
-
- Physical Medicine & Rehabilitation Physician
- New York, NY
- NPI 1215637699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1396579595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3598 ROUTE 9W STE A",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281753",
"telephone_number": "845-709-8977",
"fax_number": "845-406-4928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3598 ROUTE 9W STE A",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281753",
"telephone_number": "845-709-8977",
"fax_number": "845-406-4928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMO",
"first_name": "ANDREW",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-29",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "052697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Highland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.