Active NPI
Gerard Samiano Tayag, PT
- Physical Therapist
- Lubbock, TX
National Provider Identifier
1659470631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1076842
- Practice address
- 4601 S Loop 289 Ste 11
Lubbock, TX 79424-2206 - Phone
- (806) 792-7200
- NPI assigned
- Sep 22, 2006
- 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 | 1076842 | TX | Primary |
Addresses
Primary practice location
4601 S Loop 289 Ste 11
Lubbock, TX 79424-2206
Mailing address
1910 75TH St
Lubbock, TX 79423-1612
Phone (806) 748-5474
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 |
|---|---|---|---|
| 1076842 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CSK Medical Partners | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659470631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 75TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794231612",
"telephone_number": "806-748-5474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 S LOOP 289 STE 11",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794242206",
"telephone_number": "806-792-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYAG",
"first_name": "GERARD",
"middle_name": "SAMIANO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1076842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.