Individual provider Active NPI

Timothy Glen Gaulton, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Philadelphia, PA
National Provider Identifier
1861755852
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
MD457474 Issued in PA
Practice address
3400 Spruce St.
Philadelphia, PA 19104-3309
Phone
(215) 349-8310
Fax
(215) 893-7270
NPI assigned
Jun 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD457474 PA
Anesthesiology Physician 207L00000X 293047 MA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 293047 MA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X MD457474 PA Primary

Addresses

Primary practice location

3400 Spruce St.
Philadelphia, PA 19104-3309

Mailing address

3400 Spruce St.
Philadelphia, PA 19104-3309
Phone (215) 349-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160726002345 PA Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 3274826490 Reassigns benefits to 1 organization
I20221121002390 MA Practitioner - Critical Care (Intensivists)Practitioner - Anesthesiology 3274826490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Anesthesiology
Education
Perelman School of Med at the University of Pennsylvania, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD457474PAMDAnesthesiology Physician
293047MAMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients
General Hospital Corp Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2016 Accepting new patients
Massachusetts General Physicians Organization Inc Critical Care Medicine CurrentSince Oct 1, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
The General Hospital Corporation CurrentSince Oct 1, 2022 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Interoperability endpoints

  • Direct secure messaging: gaulton.timothy.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1861755852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-349-8310",
            "fax_number": "215-893-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-349-8310",
            "fax_number": "215-893-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULTON",
        "first_name": "TIMOTHY",
        "middle_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD457474",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "293047",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MA",
            "license": "293047",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "PA",
            "license": "MD457474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.