KATIE MARIE GILMER MS, LADC
NPI 1366195729
Counselor - Addiction (Substance Use Disorder) in Rochester, MN

NPI Status: Active since January 26, 2022

Contact Information

604 5TH ST SW
ROCHESTER, MN
ZIP 55902
Phone: (507) 225-1800

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Counselor
Addiction (Substance Use Disorder)
Accepts Insurance
Opted-Out Medicare

About KATIE GILMER

This page provides the complete NPI Profile along with additional information for Katie Gilmer, a provider established in Rochester, Minnesota with a medical specialization in Counselor, focusing in addiction (substance use disorder) . The healthcare provider is registered in the NPI registry with number 1366195729 assigned on January 2022. The practitioner's primary taxonomy code is 101YA0400X with license number 306030 (MN). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI: 1366195729
Provider Name: KATIE MARIE GILMER MS, LADC
Gender: Female
Entity Type: Individual
Location Address: 604 5TH ST SW ROCHESTER, MN 55902
Location Phone: (507) 225-1800
Mailing Address: 936 41ST ST NW APT C216 ROCHESTER, MN 55901
Mailing Phone: (507) 581-2570
Is Sole Proprietor?: No
Enumeration Date: 01-26-2022
Last Update Date: 01-26-2022
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A Substance Abuse or Addiction Counselor like Katie Gilmer advices patients who experience alcoholism, drug addiction, eating disorders, mental health issues, or other mental or behavioral problems. Substance Abuse counselors provide treatment and support to help clients recover from addiction or modify problem behaviors. Many counselors incorporate the principles of 12-step programs, such as Alcoholics Anonymous (AA). They educate clients how to cope with stress and life’s issues in ways that help them recover. Counselors also help patients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Katie Gilmer opted out of Medicare effective on 02-09-2024 until 02-09-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Counselor Addiction (Substance Use Disorder)
Taxonomy Code: 101YA0400X
Type: Behavioral Health & Social Service Providers
License No.: 306030
License State: MN

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

HealthPartners

Atlas $1,300 Gold - PPO
Atlas $2,000 Standard Gold - PPO
Atlas $3,050 Plus Silver - PPO
Atlas $3,800 HSA Silver - PPO
Atlas $6,000 Standard Silver - PPO
Atlas $6,800 Plus Bronze HSA - PPO
Atlas $7,500 Standard Bronze HSA - PPO
Atlas $8,400 HSA Bronze - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Opted-Out of Medicare? Yes
Opt-Out Effective Date: 02-09-2024
Opt-Out End Date: 02-09-2026
Eligible to Order and Refer? No

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1366195729, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 1 → 2 5 → 10 → 1 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 2 + 6 + 2 + 9 + 1 + 0 + 7 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9

This NPI is valid

The calculated check digit is 9, which matches the last digit of 1366195729.