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

Individual provider Physical Therapist · NPI 1053040345

Ishmael Gibson is a Physical Therapist in Private Practice in Bronx, New York. Qualified in 2022, 4 years ago. Practices with Professional Occupational and Physical Therapy, PLLC, a 493-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

815 Hutchinson River Pkwy
Bronx, NY 10465-1887
Phone: (718) 684-4433
Fax: (718) 684-4434
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (NY)

Record details

NPI number1053040345
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 10, 2022
Last updated in NPPESJune 10, 2022
Certification dateJune 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Professional Occupational And Physical Therapy, Pllc — 493 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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