Walter M Gorack Jr., DPT, MBA, GCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006095 Issued in CT

Practice address

304 West Main Street
Suite 2 #308
Avon, CT 06001-4103

Phone

(860) 729-1196

NPI assigned

May 16, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, FL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gorehab LLC

  • Physical Therapy Clinic/Center
  • Avon, CT
  • NPI 1871328724

  FL, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1992098511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WEST MAIN STREET",
            "address_2": "SUITE 2 #308",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014103",
            "telephone_number": "860-729-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WEST MAIN STREET",
            "address_2": "SUITE 2 #308",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014103",
            "telephone_number": "860-729-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORACK",
        "first_name": "WALTER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT, MBA, GCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Joseph Gisnarian, CCP, LP
• Ruth Goldbaum, A.P.R.N.
• Richard Seth Goldberg, MD
• Kellyn Ann Goldberger, MS, BCBA, LBA
• Marcia E Goldsholl, RD, MA, CD-N
• Halina Gorecki, APRN
• Gorehab LLC
• Catherine Gormley
• Christine Gottesmann, BCBA, LBA
• Ingrid Grafals, MD

• Physical Therapist in Avon, CT
• Providers in Avon, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.