Individual provider Active NPI

Karol Peter Gasior, DPT

  • Physical Therapist
  • Traverse City, MI
National Provider Identifier
1760269492
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302722 Issued in MI
Practice address
3899 W Front St Ste 3
Traverse City, MI 49684-8104
Phone
(231) 944-6541
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 5501302722 MI Primary

Addresses

Primary practice location

3899 W Front St Ste 3
Traverse City, MI 49684-8104

Mailing address

3728 Waters Edge
Kewadin, MI 49648
Phone (231) 329-3886

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003002110 MI Practitioner - Physical Therapist in Private Practice 4183078587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Dimensions, LLCGroup PAC ID 6608026190, 11 clinicians

Practice addresses (Care Compare)

3899 W Front St
Suite 3
Traverse City, MI 49684-8104
Phone (231) 944-6541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501302722MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Dimensions LLC Physical Therapist CurrentSince Sep 7, 2023 Accepting new patients

Locations

3899 W Front St
Ste 3
Traverse City, MI 49684
Phone (231) 421-9277

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, 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": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1760269492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3728 WATERS EDGE",
            "city": "KEWADIN",
            "state": "MI",
            "postal_code": "49648",
            "telephone_number": "231-329-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 W FRONT ST STE 3",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848104",
            "telephone_number": "231-944-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASIOR",
        "first_name": "KAROL",
        "middle_name": "PETER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.