Daniel Goulette

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

055.0031230 Issued in VT

Practice address

617 Riverside Ave
Burlington, VT 05401-1601

Phone

(802) 864-6309

Fax

(802) 860-4313

NPI assigned

Nov 25, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Ideal Option, PLLC

  • Clinic/Center
  • Kennewick, WA
  • NPI 1457788275

  NM

  Medicare reassignment
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Renton, WA
  • NPI 1346754868

  NM

  Medicare reassignment
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Kennewick, WA
  • NPI 1841648623
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Covington, WA
  • NPI 1093768657
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Rosedale, MD
  • NPI 1427561828
  NPD (past)

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1285031872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 7TH ST STE A205",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572983",
            "telephone_number": "509-222-1275",
            "fax_number": "509-491-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-864-6309",
            "fax_number": "802-860-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULETTE",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-25",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055.0031230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles David Gottlieb, MSW
• Diane T Gottlieb, MSW, PH.D.
• Manoj Purna Goud
• Sarah J Goudreau, AUD
• Jonathan Gougelet, MD
• Kerry A Goulette, P.A.
• Deborah Beth Governale, PA-C
• Lacey Georgia Gowdy
• Lynn B. Goyette, MACP,MSED.
• Grace Street Recovery Services-Vermont

• Medical Physician Assistant in Burlington, VT
• Providers in Burlington, VT by specialty
• Medical Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.