Individual provider Active NPI

Adam Goltra, DPT

  • Physical Therapist
  • Castle Rock, CO
National Provider Identifier
1760934822
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0014231 Issued in CO
Practice address
725 Wilcox St
Castle Rock, CO 80104-1740
Phone
(720) 457-5535
Fax
(720) 457-5535
NPI assigned
Oct 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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 0014231 CO Primary

Addresses

Primary practice location

725 Wilcox St
Castle Rock, CO 80104-1740

Mailing address

725 Wilcox St
Castle Rock, CO 80104-1740
Phone (720) 457-5535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506000057 FL Practitioner - Physical Therapist in Private Practice 1052699642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Building Bones and Balance LLCGroup PAC ID 6709024631, 4 clinicians

Practice addresses (Care Compare)

2100 E Hallandale Beach Blvd
Suite 400
Hallandale Beach, FL 33009-3772
Phone (786) 763-2272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Building Bones and Balance, LLC Physical Therapist CurrentSince Apr 24, 2024 Accepting new patients

Locations

1835 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 224-2191

2100 E Hallandale Beach Blvd
Ste 400
Hallandale Beach, FL 33009
Phone (786) 763-2272

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": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1760934822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WILCOX ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041740",
            "telephone_number": "720-457-5535",
            "fax_number": "720-457-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WILCOX ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041740",
            "telephone_number": "720-457-5535",
            "fax_number": "720-457-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLTRA",
        "first_name": "ADAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0014231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.