Dr Kathryn Theresa Gollotto, DO is a medicare enrolled "Physical Medicine & Rehabilitation - Sports Medicine" physician in Stateline, Nevada. Her current practice location is
165 Highway 50, Stateline, Nevada. You can reach out to her office (for appointments etc.) via phone at
(775) 589-8915.
Dr Kathryn Theresa Gollotto is licensed to practice in Nevada (license number 25MB08571200) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730302274.
Physician's Profile
| Full Name | Dr Kathryn Theresa Gollotto |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation - Sports Medicine |
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| Location | 165 Highway 50, Stateline, Nevada |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730302274
- Provider Enumeration Date: 04/11/2007
- Last Update Date: 12/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 9537206172
- Enrollment ID: I20211117002238
Medical Identifiers
Medical identifiers for Dr Kathryn Theresa Gollotto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730302274 | NPI | - | NPPES |
| 25MB08571200 | Other | NJ | LICENSE |
| OT011173 | Other | PA | TRAINING LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 25MB08571200 (Nevada) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | OT011173 (Nevada) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kathryn Theresa Gollotto allows following entities to bill medicare on her behalf.
| Entity Name | Barton Medical Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750950499
PECOS PAC ID: 5395127682
Enrollment ID: O20230302002928 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kathryn Theresa Gollotto is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kathryn Theresa Gollotto, DO
2170 South Ave,
South Lake Tahoe, CA 96150-7026
Ph: (530) 541-3420 | Dr Kathryn Theresa Gollotto, DO
165 Highway 50,
Stateline, NV 89449-9816
Ph: (775) 589-8915 |
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