Individual provider Active NPI

Benjamin Gutzky, PT,DPT

  • Physical Therapist
  • Middlefield, OH
National Provider Identifier
1700523339
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
14950 S Springdale Ave
Middlefield, OH 44062-9661
Phone
(440) 993-1004
Fax
(440) 574-7254
NPI assigned
May 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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 Primary

Addresses

Primary practice location

14950 S Springdale Ave
Middlefield, OH 44062-9661

Mailing address

PO Box 987
Middlefield, OH 44062-0987
Phone (440) 993-1004

Other identifiers 1

IdentifierTypeStateIssuer
PT019836OtherOHSTATE OTPTAT BOARD LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Info@myofitclinic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220610001338 OH Practitioner - Physical Therapist in Private Practice 7911385513 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Link LLC 27 clinicians

Practice addresses (Care Compare)

7617 Dayton Springfield Rd
Fairborn, OH 45324-3560
Phone (937) 340-6063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Pain Services, PLL CurrentSince May 22, 2023 Accepting new patients
Toledo Pain Services, PLL CurrentSince May 22, 2023 Accepting new patients
Cramer Physical Therapy, LLC CurrentSince May 23, 2022 Accepting new patients
PT Link LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Hallett Enterprises, LLC Physical Therapist Past Accepting new patients
Steward Medical Group, Inc PastSince May 22, 2022 Accepting new patients

Locations

7617 Dayton Springfield Rd
Fairborn, OH 45324
Phone (937) 340-6063

1823 W State St
Fremont, OH 43420
Phone (419) 334-7737

110 S Church St
New Carlisle, OH 45344
Phone (937) 845-0260

846 S Coy Rd
Ste 100
Oregon, OH 43616

1030 Hayes Ave
Sandusky, OH 44870

4210 W Sylvania Ave
Ste 102
Toledo, OH 43623
Phone (419) 350-3347

4349 Talmadge Rd
Toledo, OH 43623
Phone (419) 654-8818

5151 Monroe St
Ste 104
Toledo, OH 43623

3400 Meijer Dr
Toledo, OH 43617
Phone (419) 531-3500

Organizations & group practices 6

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1700523339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 987",
            "city": "MIDDLEFIELD",
            "state": "OH",
            "postal_code": "440620987",
            "telephone_number": "440-993-1004",
            "fax_number": "440-574-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14950 S SPRINGDALE AVE",
            "city": "MIDDLEFIELD",
            "state": "OH",
            "postal_code": "440629661",
            "telephone_number": "440-993-1004",
            "fax_number": "440-574-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTZKY",
        "first_name": "BENJAMIN",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OTPTAT BOARD LICENSE",
            "identifier": "PT019836",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Info@myofitclinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14950 S Springdale Ave",
            "city": "Middlefield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440629661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middlefield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.