Individual provider Active NPI

Tyler Joseph Gajdos, PT, DPT

  • Skilled Nursing Facility
  • Cleveland, OH
National Provider Identifier
1700239894
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PT016053 Issued in OH
Practice address
4398 W 19TH St
Cleveland, OH 44109-3638
Phone
(216) 789-1441
NPI assigned
Jul 13, 2016
Last updated
Jul 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X PT016053 OH Primary

Addresses

Primary practice location

4398 W 19TH St
Cleveland, OH 44109-3638

Mailing address

4398 W 19TH St
Cleveland, OH 44109-3638
Phone (216) 789-1441

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT016053OHMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1700239894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4398 W 19TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093638",
            "telephone_number": "216-789-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4398 W 19TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093638",
            "telephone_number": "216-789-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJDOS",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "PT016053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.