Daniel A Gullotta, P.T.,M.A.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

741PT Issued in MT

Practice address

211A Main St
Polson, MT 59860-2119

Phone

(406) 883-8101

Fax

(406) 883-8102

NPI assigned

Jul 28, 2005

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Daniel a Gullotta PT

  • Physical Therapist
  • Polson, MT
  • NPI 1063711778
  NPD (past) Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1194725416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211A MAIN ST",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598602119",
            "telephone_number": "406-883-8101",
            "fax_number": "406-883-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211A MAIN ST",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598602119",
            "telephone_number": "406-883-8101",
            "fax_number": "406-883-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLOTTA",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.T.,M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MT",
            "license": "741PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPT BC/BS",
            "identifier": "062065",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650018165",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0342244",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPT BCBS",
            "identifier": "061605",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348556",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul D Gochis, MD
• Megan Lill Gran, DPT
• Milissa Renee Grandchamp, NP
• Natasha Suzanne Gregg, LCPC
• Guiding Sage Counseling
• Aimee Jean Gustafson, D.D.S.
• Aron Haire, DO
• Jacob Alton Halgren, DPT
• Anthony Milton Hallock, PHARM.D.
• Mariah Hamel

• Physical Medicine & Rehabilitation Physician in Polson, MT
• Providers in Polson, MT by specialty
• Physical Medicine & Rehabilitation Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.