Active NPI
Michael Phillip Gerstein
- Physical Therapy Assistant
- Layton, UT
National Provider Identifier
1982278057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 12104034-2402
- Practice address
- 1205 N Fairfield Rd
Layton, UT 84041-8300 - Phone
- (801) 876-5980
- NPI assigned
- May 13, 2021
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 12104034-2402 | UT | Primary |
Addresses
Primary practice location
1205 N Fairfield Rd
Layton, UT 84041-8300
Mailing address
251 Park Blvd Apt 211
Ogden, UT 84401-0553
Phone (248) 875-5036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12104034-2402 | Other | UT | PTA LICENSE NUMBER |
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 |
|---|---|---|---|
| 12104034-2402 | UT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1982278057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 PARK BLVD APT 211",
"city": "OGDEN",
"state": "UT",
"postal_code": "844010553",
"telephone_number": "248-875-5036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 N FAIRFIELD RD",
"city": "LAYTON",
"state": "UT",
"postal_code": "840418300",
"telephone_number": "801-876-5980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSTEIN",
"first_name": "MICHAEL",
"middle_name": "PHILLIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-13",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "UT",
"license": "12104034-2402",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA LICENSE NUMBER",
"identifier": "12104034-2402",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.