Individual provider Active NPI

John Gil Fletcher, P.T.

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1780628883
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003318 Issued in NY
Practice address
1911 Richmond Ave
Suite 130
Staten Island, NY 10314-3913
Phone
(718) 982-6496
Fax
(718) 982-6751
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 003318 NY Primary

Addresses

Primary practice location

1911 Richmond Ave
Suite 130
Staten Island, NY 10314-3913

Mailing address

1911 Richmond Ave
Suite 130
Staten Island, NY 10314-3913
Phone (718) 982-6496

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
003318NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780628883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 RICHMOND AVE",
            "address_2": "SUITE 130",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143913",
            "telephone_number": "718-982-6496",
            "fax_number": "718-982-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 RICHMOND AVE",
            "address_2": "SUITE 130",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143913",
            "telephone_number": "718-982-6496",
            "fax_number": "718-982-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JOHN",
        "middle_name": "GIL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "003318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.