Individual provider Active NPI

Douglas A Gulick, P.T.

  • Physical Therapist
  • Alhambra, CA
National Provider Identifier
1679645790
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11915 Issued in CA
Practice address
55 S Raymond Ave
Ste 100
Alhambra, CA 91801-7100
Phone
(626) 576-0591
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 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 PT11915 CA Primary

Addresses

Primary practice location

55 S Raymond Ave
Ste 100
Alhambra, CA 91801-7100

Mailing address

1008 N Dos Robles PL
Alhambra, CA 91801-1221
Phone (626) 289-8095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120519000005 CA Practitioner - Physical Therapist in Private Practice 2264695725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yonemoto Physical Therapy Services IncGroup PAC ID 4880786219, 6 clinicians

Practice addresses (Care Compare)

55 S Raymond Ave
Suite 100
Alhambra, CA 91801-7101
Phone 626576059127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT11915CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yonemoto Physical Therapy Services Inc. Physical Therapist CurrentSince Mar 18, 2012 Accepting new patients

Locations

55 S Raymond Ave
Ste 100
Alhambra, CA 91801
Phone (626) 576-0591

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1679645790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N DOS ROBLES PL",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011221",
            "telephone_number": "626-289-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S RAYMOND AVE",
            "address_2": "STE 100",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017100",
            "telephone_number": "626-576-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULICK",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.