Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gavin Connor Dibble, DPT

Individual provider Physical Therapist · NPI 1396587259

Gavin Connor Dibble, DPT is a Physical Therapist in Private Practice in Selden, New York. Qualified in 2024, 2 years ago. Practices with Affinity Rehabilitation LLP, a 114-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2024
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1312 Middle Country Rd
Selden, NY 11784-2514
Phone: (631) 732-0700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 052589 (NY)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1396587259
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 11, 2024
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing address197 Pointe Cir N, Coram, NY 11727-1542

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Affinity Rehabilitation Llp — 114 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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