Individual provider Active NPI

Gaebriel Gaitano

  • Physical Therapist
  • Milford, DE
National Provider Identifier
1720452204
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0002888 Issued in DE
Practice address
1017 Mattlind Way
Milford, DE 19963-5369
Phone
(302) 514-9597
NPI assigned
Nov 19, 2015
Last updated
Sep 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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 J1-0002888 DE Primary

Addresses

Primary practice location

1017 Mattlind Way
Milford, DE 19963-5369

Mailing address

23058 Meadow Wood CT Unit 207
Seaford, DE 19973-7743

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170516000348 DE Practitioner - Physical Therapist in Private Practice 2163709429 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0002888DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Care Physical Therapy Inc Physical Therapist CurrentSince Aug 13, 2018 Accepting new patients
Lakeside Physical Therapy, LLC Physical Therapist CurrentSince Feb 1, 2017 Accepting new patients
Saints Home Healthcare, LLC PastSince Oct 10, 2021 Accepting new patients

Locations

404 E Front St
Laurel, DE 19956
Phone (302) 280-6920

24488 Sussex Hwy
Ste 2
Seaford, DE 19973
Phone (302) 629-5766

Organizations & group practices 3

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1720452204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23058 MEADOW WOOD CT UNIT 207",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199737743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 MATTLIND WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199635369",
            "telephone_number": "302-514-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITANO",
        "first_name": "GAEBRIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.