Active NPI
Gennadiy Gandelsman, DPT
- Physical Therapist
- Cambridge, MA
National Provider Identifier
1447520390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24832
- Practice address
- 163 Gore St
Cambridge, MA 02141-1119 - Phone
- (617) 575-5850
- NPI assigned
- Jan 10, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24832 | MA | Primary |
| Physical Therapist | 225100000X | 033989 | NY |
Addresses
Primary practice location
163 Gore St
Cambridge, MA 02141-1119
Mailing address
163 Gore St
Cambridge, MA 02141-1119
Phone (617) 575-5850
Other practice location 1
161 Atlantic Ave
Brooklyn, NY 11201-6792
Phone (718) 852-6030
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24832 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feel Good Physical Therapy, PC | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Brooklyn, NY
- NPI 1821109752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1447520390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 GORE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021411119",
"telephone_number": "617-575-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 GORE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021411119",
"telephone_number": "617-575-5850"
}
],
"practiceLocations": [
{
"address_1": "161 Atlantic Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112016792",
"country_code": "US",
"telephone_number": "718-852-6030",
"fax_number": "718-852-5290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GANDELSMAN",
"first_name": "GENNADIY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-10",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "24832",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "033989",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.