Mary Kay Gavlek, PT
Individual provider Active NPI Physical Therapist · Escanaba, MI
NPI 1962904763 · NPPES record last updated Dec 14, 2022
Key facts
- NPI
- 1962904763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501002977 (MI)
- Practice address
- 610 S Lincoln Rd
Escanaba, MI 49829-1215 - Phone
- (906) 786-6488
- Fax
- (906) 786-6409
- NPI assigned
- Mar 7, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oconto Hospital and Medical Center Inc
Bellin Memorial Hospital Inc
Practice addresses (Care Compare)
106 S School Rd
Daggett, MI 49821-8555
Phone (906) 753-2155
218 S Hwy 141
Crivitz, WI 54114-1677
Phone (715) 854-7477
610 S Lincoln Rd
Bellin Health
Escanaba, MI 49829-1215
Phone (906) 786-6488
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210802001957 | MI | Practitioner - Physical Therapist in Private Practice | 5597169334 | Reassigns benefits to 2 organizations |
| I20230126003511 | WI | Practitioner - Physical Therapist in Private Practice | 5597169334 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501002977 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconto Hospital & Medical Center, Inc. | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Physical Therapist | Current |
Accepting new patients |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current |
Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Past | Accepting new patients |
Locations
106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155
610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488
440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040
1100 10th St
Menominee, MI 49858
Phone (906) 863-2256
218 S US Highway 141
Crivitz, WI 54114
Phone (715) 854-7477
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
744 S Webster Ave
Fl 7
Green Bay, WI 54301
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501002977 | MI | Yes |
Addresses
Primary practice location
610 S Lincoln Rd
Escanaba, MI 49829-1215
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040
Other practice location 2
7870W US Highway 2
Manistique, MI 49854-8992
Phone (906) 341-3254
Other practice location 3
106 S School Rd
Daggett, MI 49821-8555
Phone (906) 753-2155
Other providers in Escanaba, MI
- John Michael Gagnon
- Gartland Family Vision
- Leanne Gartland
- Eda Mariela Gatien
- Kimber M Gauthier
- Paul R Gayeff
- Andrew James Gearhart
- Lori Geiger
- Melissa Germain
- Brian Giffin
All providers in Escanaba, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.