Active NPI
Samuel Guba
- Physical Therapist
- Ballston Lake, NY
National Provider Identifier
1982078838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 037809
- Practice address
- 457 Schauber Rd
Ballston Lake, NY 12019-2321 - Phone
- (518) 573-0864
- NPI assigned
- Nov 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 037809 | NY | Primary |
Addresses
Primary practice location
457 Schauber Rd
Ballston Lake, NY 12019-2321
Mailing address
457 Schauber Rd
Ballston Lake, NY 12019-2321
Phone (518) 573-0864
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037809 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1982078838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "457 SCHAUBER RD",
"city": "BALLSTON LAKE",
"state": "NY",
"postal_code": "120192321",
"telephone_number": "518-573-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "457 SCHAUBER RD",
"city": "BALLSTON LAKE",
"state": "NY",
"postal_code": "120192321",
"telephone_number": "518-573-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUBA",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "037809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballston Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.