Individual provider Active NPI

Gary Diekhoff, DPT

  • Physical Therapist
  • Cedar Park, TX
National Provider Identifier
1912262106
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1219300 Issued in TX
Practice address
1335 E Whitestone Blvd BLDG O100
Cedar Park, TX 78613-0047
Phone
(512) 539-0032
Fax
(512) 539-0034
NPI assigned
Jul 12, 2012
Last updated
Jul 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 1219300 TX Primary

Addresses

Primary practice location

1335 E Whitestone Blvd BLDG O100
Cedar Park, TX 78613-0047

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028000747 TX Practitioner - Physical Therapist in Private Practice 8325273469 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
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

14902 Preston Rd
Suite 410
Dallas, TX 75254-9131
Phone (469) 778-7655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1219300TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 8, 2020 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 8, 2020 Accepting new patients
Agilitas USA, Inc PastSince Aug 2, 2020 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1335 E Whitestone Blvd
#100
Cedar Park, TX 78613
Phone (512) 539-0032

1335 E Whitestone Blvd
Bldg O100
Cedar Park, TX 78613
Phone (512) 539-0032

14902 Preston Rd
Ste 410
Dallas, TX 75254
Phone (469) 778-7655

10100 Katy Fwy
Ste 170
Houston, TX 77043
Phone (832) 795-9175

3351 Regent Blvd
Ste 140A
Irving, TX 75063
Phone (214) 774-2995

2735 Town Center Blvd N
Ste N
Sugar Land, TX 77479
Phone (281) 728-7734

5601 Brodie Ln
Sunset Valley, TX 78745
Phone (512) 580-3055

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1912262106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 E WHITESTONE BLVD BLDG O100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786130047",
            "telephone_number": "512-539-0032",
            "fax_number": "512-539-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEKHOFF",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1219300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.