Individual provider Active NPI

Daniele Gastineau, PT

  • Physical Therapist
  • Kalispell, MT
National Provider Identifier
1407919343
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1644PT
Practice address
770 W Reserve Dr
Kalispell, MT 59901-2130
Phone
(406) 861-3472
Fax
(406) 862-5600
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1644PT Primary

Addresses

Primary practice location

770 W Reserve Dr
Kalispell, MT 59901-2130

Mailing address

6970 Farm to Market Rd
Whitefish, MT 59937-8303
Phone (406) 261-3472

Other identifiers 2

IdentifierTypeStateIssuer
61918OtherMTBLUE CROSS / BLUE SHIELD
3400293MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000778 MT Practitioner - Physical Therapist in Private Practice 3577531763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastineau Physical Therapy, LTD.Group PAC ID 6507834793, 2 clinicians

Practice addresses (Care Compare)

2316 US Hwy 93 N
Kalispell, MT 59901-2547
Phone (406) 755-3991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1644MTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastineau Physical Therapy, LTD. CurrentSince Sep 1, 2004 Accepting new patients

Locations

175 Hutton Ranch Rd
Ste 3
Kalispell, MT 59901

770 W Reserve Dr
Kalispell, MT 59901
Phone (406) 253-3276

175 Hutton Ranch Rd
Ste 103
Kalispell, MT 59901
Phone (406) 652-1588

2316 US Highway 93 N
Kalispell, MT 59901
Phone (406) 755-3991

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1407919343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6970 FARM TO MARKET RD",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599378303",
            "telephone_number": "406-261-3472",
            "fax_number": "406-862-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W RESERVE DR",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012130",
            "telephone_number": "406-861-3472",
            "fax_number": "406-862-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTINEAU",
        "first_name": "DANIELE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "1644PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "61918",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400293",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.