Gavin Connor Dibble, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

052589 Issued in NY

Practice address

1312 Middle Country Rd
Selden, NY 11784-2514

Phone

(631) 732-0700

NPI assigned

Jun 11, 2024

Last updated

May 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affinity Rehabilitation LLPGroup PAC ID 4789843376, 114 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affinity Rehabilitation LLP

  • Physical Therapy Clinic/Center
  • De Witt, NY
  • NPI 1346530169
  Medicare reassignment Care Compare group NPD
• Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC

  • Physical Therapist
  • Holbrook, NY
  • NPI 1326355132
  Medicare reassignment NPD
• Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC

  • Occupational Therapist
  • Garden City, NY
  • NPI 1356742365

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1396587259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 POINTE CIR N",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271542",
            "telephone_number": "631-566-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 MIDDLE COUNTRY RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842514",
            "telephone_number": "631-732-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "GAVIN",
        "middle_name": "CONNOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Dellorusso, LMT
• Joy Delorenzo, ATC
• Christine Caroline Demato, RN
• Petrina Loree Derobertis, LMT
• Edwin Manuel Diaz, OTRL
• Patricia Diefenbach
• Diana Rose Diem
• Sam Digiovanna, RPH
• Monica Dimitrakakis
• Anthony Disanti, DDS

• Physical Therapist in Selden, NY
• Providers in Selden, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.