Individual provider Active NPI

Joseph Gambino Jr., DPT, CSCS

  • Physical Therapist
  • Draper, UT
National Provider Identifier
1922479021
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P99799 Issued in NY
Practice address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone
(385) 308-8034
NPI assigned
Oct 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 P99799 NY Primary

Addresses

Primary practice location

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096

Mailing address

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P99799NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1922479021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "385-308-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "385-308-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINO",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "P99799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.