NPIMap

Individual provider Active NPI

Daniel Lee Gatlin, M.D.

  • Surgery Physician
  • West Saint Paul, MN
National Provider Identifier
1124074414
Registry record updated Sep 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
47204 Issued in MN
Practice address
142 Westchester Dr
West Saint Paul, MN 55118-2511
Phone
(651) 457-7171
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 47204 MN
Surgery Physician 208600000X 47204 MN Primary

Addresses

Primary practice location

142 Westchester Dr
West Saint Paul, MN 55118-2511

Mailing address

142 Westchester Dr
West Saint Paul, MN 55118-2511
Phone (651) 457-7171

Other identifiers 1

IdentifierTypeStateIssuer
034990900MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000046 MN Practitioner - General Surgery 6406809219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 993-7750

1515 Saint Francis Ave
Shakopee, MN 55379-3387
Phone (952) 993-7750

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)39
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47204MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Jul 14, 2008 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 14, 2008 Accepting new patients
St Francis Regional Medical Center Past Accepting new patients

Locations

14050 Fairview Dr
Burnsville, MN 55337
Phone (612) 499-8548

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

1515 Saint Francis Ave
Ste 145
Shakopee, MN 55379
Phone (952) 241-5873

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474675200000",
    "number": "1124074414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 WESTCHESTER DR",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551182511",
            "telephone_number": "651-457-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 WESTCHESTER DR",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551182511",
            "telephone_number": "651-457-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLIN",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "47204",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "47204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034990900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.