Jason Gulstrom, PT

Individual provider Active NPI Physical Therapist · Appomattox, VA

NPI 1093480170 · NPPES record last updated Aug 11, 2021

Key facts

NPI
1093480170
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2305214485 (VA)
Practice address
571 Court Street
Appomattox, VA 24522-2450
Phone
(434) 352-5799
Fax
(434) 509-1695
NPI assigned
Aug 11, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates of Central Virginia Limited Partnership (54 clinicians)

Practice addresses (Care Compare)

571 Court St
Appomattox, VA 24522-8212
Phone (737) 352-5799

Merit-based Incentive Payment System (MIPS)

Final score
91.57 of 100 (group)
Quality
98.54
Improvement activities
40
Cost
74.59

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211001000156 VA Practitioner - Physical Therapist in Private Practice 0648677831 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist Current
since Aug 2, 2021
Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist Current
since Aug 2, 2021
Accepting new patients

Locations

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

14339 Wards Rd
Ste C
Lynchburg, VA 24502
Phone (434) 226-0224

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305214485 VA Yes

Addresses

Primary practice location

571 Court Street
Appomattox, VA 24522-2450

Mailing address

20347 Timberlake Rd Ste B
Lynchburg, VA 24502-7352
Phone (434) 352-5799

Other providers in Appomattox, VA

All providers in Appomattox, VA · Physical Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.