Individual provider Active NPI

James M. Gucciardo, DPT

  • Physical Therapist
  • Commack, NY
National Provider Identifier
1881278596
Registry record updated May 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046751 Issued in NY
Practice address
763 Larkfield Rd Ste 101
Commack, NY 11725-3131
Phone
(631) 462-0118
Fax
(631) 462-0827
NPI assigned
May 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2021

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 046751 NY Primary

Addresses

Primary practice location

763 Larkfield Rd Ste 101
Commack, NY 11725-3131

Mailing address

533 Hunter Ave
West Islip, NY 11795-1637
Phone (631) 813-0773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501000891 NY Practitioner - Physical Therapist in Private Practice 6901374503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Generational Physical TherapyGroup PAC ID 4284085820, 2 clinicians

Practice addresses (Care Compare)

233 Bertram PL
Bethpage, NY 11714-4201
Phone (631) 379-5810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046751NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chris Prentiss Physical Therapy PC Physical Therapist CurrentSince May 16, 2021 Accepting new patients

Locations

763 Larkfield Rd
Ste 101
Commack, NY 11725
Phone (631) 462-0118

Organizations & group practices 2

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": "1620518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620518400000",
    "number": "1881278596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 HUNTER AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951637",
            "telephone_number": "631-813-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 LARKFIELD RD STE 101",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253131",
            "telephone_number": "631-462-0118",
            "fax_number": "631-462-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUCCIARDO",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-09",
        "last_updated": "2021-05-09",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2021; 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.