Andrew Charles Gorecki, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501014611 Issued in MI

Practice address

3899 W Front St
Unit 3
Traverse City, MI 49684-8103

Phone

(231) 932-9014

Fax

(231) 932-9034

NPI assigned

Jan 15, 2010

Last updated

May 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

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)

Merit-based Incentive Payment System (MIPS)

Final score

30 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

100

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Functional Dimensions LLC

  dba Superior Physical Therapy

  • Physical Therapist
  • Traverse City, MI
  • NPI 1750661542
  Medicare reassignment Care Compare group NPD Authorized official
• Functional Dimensions LLC

  • Orthopedic Physical Therapist
  • Traverse City, MI
  • NPI 1780076232
  NPD Authorized official
• Accelerated Mobility Physical Therapy LLC

  dba FYZICAL Therapy & Balance Center

  • Physical Therapy Clinic/Center
  • Traverse City, MI
  • NPI 1295887594

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1902137920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 EASTERN SKY DR STE 6",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847351",
            "telephone_number": "231-932-9014",
            "fax_number": "231-932-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 W FRONT ST",
            "address_2": "UNIT 3",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848103",
            "telephone_number": "231-932-9014",
            "fax_number": "231-932-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORECKI",
        "first_name": "ANDREW",
        "middle_name": "CHARLES",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4797005",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0B81315",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley P Goodwin, M.D.
• Jeffrey D Goodwin, M.DIV, M.A., LLPC
• Zachary Peter Goral, D.O.
• David S Gordon, MD
• Clinton K. Gore, DDS
• John J Gorman, M.D.
• Katherine A Gorman, D.C.
• Terry Gorton
• Margaret Anne Goss, M.A. CCC-SLP
• Linda Gossett, MD

• Physical Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.