Individual provider Active NPI

Jason S Gumprecht, PT

  • Physical Therapist
  • Johnson City, NY
National Provider Identifier
1457600546
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035275 Issued in NY
Practice address
401 Main Street
Johnson City, NY 13790-2018
Phone
(607) 798-8800
Fax
(607) 798-8801
NPI assigned
Sep 5, 2012
Last updated
Sep 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 035275 NY Primary

Addresses

Primary practice location

401 Main Street
Johnson City, NY 13790-2018

Mailing address

601 Gates Road
Suite 3
Vestal, NY 13850-2288
Phone (607) 584-7389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616000982 NJ Practitioner - Physical Therapist in Private Practice 6901056803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shore Regional Home TherapiesGroup PAC ID 0547621658, 5 clinicians

Practice addresses (Care Compare)

78 Mystic CT
Cliffwood, NJ 07721-1501
Phone (732) 581-8688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1457600546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATES ROAD",
            "address_2": "SUITE 3",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502288",
            "telephone_number": "607-584-7389",
            "fax_number": "607-772-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MAIN STREET",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902018",
            "telephone_number": "607-798-8800",
            "fax_number": "607-798-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMPRECHT",
        "first_name": "JASON",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.