Individual provider Active NPI

Jonathan Gustke, COTA/L

  • Occupational Therapy Assistant
  • Amherst, NY
National Provider Identifier
1871155648
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
010091-1 Issued in NY
Practice address
95 John Muir Drive
Amherst, NY 14228
Phone
(800) 543-9399
NPI assigned
Jul 2, 2019
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 010091-1 NY Primary

Addresses

Primary practice location

95 John Muir Drive
Amherst, NY 14228

Mailing address

121 Haskins LN N
Hilton, NY 14468-8957
Phone (585) 766-1991

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
010091-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1871155648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HASKINS LN N",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "144688957",
            "telephone_number": "585-766-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 JOHN MUIR DRIVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14228",
            "telephone_number": "800-543-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTKE",
        "first_name": "JONATHAN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "010091-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.