Individual provider Active NPI

Corey Gaul, M.D.

  • Emergency Medicine Physician
  • Polson, MT
National Provider Identifier
1992230239
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MED-PHYS-LIC-83216 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860-5315
Phone
(406) 883-5680
Fax
(406) 883-8910
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 58568 AZ
Emergency Medicine Physician 207P00000X R76048 AZ
Emergency Medicine Physician 207P00000X MED-PHYS-LIC-83216 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860-5315

Mailing address

PO Box 262
Liberty Lake, WA 99019-0262
Phone (667) 472-4558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200722000267 MT Practitioner - Emergency Medicine 5698030104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Fork Emergency Physicians PLLCGroup PAC ID 1850491960, 8 clinicians

Practice addresses (Care Compare)

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (406) 728-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.37 of 100Reported as group
Quality
77.14
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R76048AZMDEmergency Medicine Physician
MED-PHYS-LIC-83216MTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Fork Emergency Physicians PLLC Emergency Medicine CurrentSince Oct 14, 2023 Accepting new patients
RCHP Billings - Missoula LLC Current Accepting new patients

Locations

8 Oak Park Dr
Bedford, MA 01730
Phone (781) 280-1527

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

Interoperability endpoints

  • Direct secure messaging: cgaul@direct.communitymed.org

Organizations & group practices 2

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1992230239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190262",
            "telephone_number": "667-472-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUL",
        "first_name": "COREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "58568",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R76048",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-83216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.