Individual provider Active NPI

Michael Gambero, PT, DPT

  • Orthopedic Physical Therapist
  • Fresno, CA
National Provider Identifier
1902148034
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
39942 Issued in CA
Practice address
6049 N. First St.
Fresno, CA 93710
Phone
(559) 432-0524
NPI assigned
Mar 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 39942 CA Primary

Addresses

Primary practice location

6049 N. First St.
Fresno, CA 93710

Mailing address

6366 N. Eighth
Fresno, CA 93710

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002990 CA Practitioner - Physical Therapist in Private Practice 8921226283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Aquatic Therapy IncGroup PAC ID 2769818327, 2 clinicians

Practice addresses (Care Compare)

7005 N Chestnut Ave
Suite 102
Fresno, CA 93720-0348
Phone (559) 323-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39942CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Aquatic Therapy Inc CurrentSince May 30, 2023 Accepting new patients
Advanced Physical and Occupational Therapy Orthopedic Past Accepting new patients

Locations

7005 N Chestnut Ave
Ste 102
Fresno, CA 93720
Phone (559) 323-4100

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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1902148034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6366 N. EIGHTH",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6049 N. FIRST ST.",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-432-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBERO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.