Individual provider Active NPI

Amanda K Gottschalk, MPT

  • Physical Therapist
  • Altamonte Springs, FL
National Provider Identifier
1801019708
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19571 Issued in FL
Practice address
901 Douglas Ave Ste 105
Altamonte Springs, FL 32714-2058
Phone
(407) 865-7153
Fax
(407) 865-7159
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT19571 FL
Physical Therapist 225100000X P17203 NC
Orthopedic Physical Therapist 2251X0800X PT020341 OH
Physical Therapist 225100000X PT19571 FL Primary

Addresses

Primary practice location

901 Douglas Ave Ste 105
Altamonte Springs, FL 32714-2058

Mailing address

336 Broad St Ste 203
Rome, GA 30161-3006
Phone (407) 865-7153

Other practice location 1

303 N 35th St
Morehead City, NC 28557-3105
Phone (252) 247-2738

Other practice location 2

224 W Central Pkwy Ste 1018
Altamonte Springs, FL 32714-2545
Phone (407) 389-1092

Other practice location 3

5844 Darrow Rd
Hudson, OH 44236-3864
Phone (330) 650-6767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622002824 OH Practitioner - Physical Therapist in Private Practice 2466711627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3340 W Market St
Suite 200
Fairlawn, OH 44333-3381

PO Box
Cleveland, OH 44192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT19571FLMDPhysical Therapist
PT020341OHMDOrthopedic Physical Therapist

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Ability Health Services, Inc Past Accepting new patients
Breakthrough Physical Therapy Physical Therapist PastSince Nov 1, 2017 Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1801019708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BROAD ST STE 203",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613006",
            "telephone_number": "407-865-7153",
            "fax_number": "407-865-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOUGLAS AVE STE 105",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142058",
            "telephone_number": "407-865-7153",
            "fax_number": "407-865-7159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N 35th St",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285573105",
            "country_code": "US",
            "telephone_number": "252-247-2738",
            "fax_number": "252-240-3882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 W Central Pkwy Ste 1018",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327142545",
            "country_code": "US",
            "telephone_number": "407-389-1092",
            "fax_number": "407-389-1097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5844 Darrow Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "OH",
            "postal_code": "442363864",
            "country_code": "US",
            "telephone_number": "330-650-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT19571",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17203",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT020341",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.