MS. TRISTA M GOTTWALT (MS, LADC) – Mental Health Counselor, NPI 1184291049

MS. TRISTA M GOTTWALT (MS, LADC) is a healthcare provider. based in Edina, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS, LADC. They hold a License No. 306045 (MN). The NPI Number for MS. TRISTA M GOTTWALT (MS, LADC) is 1184291049

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MS. TRISTA M GOTTWALT (MS, LADC)
NPI
1184291049
Phone
(763) 537-6000
Address
7400 France Ave S Ste 100
Enumeration Date
9 June 2021
Last Update Date
19 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635376000
Graduation Year
2021 (5 years ago)
PAC ID
5698110567
Group Practice PAC ID
2769378942
Professional Enrollment ID
I20240301000682
Address ID
MN554333046MI2104XNWXX402
Telehealth
Yes

Contacts

Secure Messaging
trista.gottwalt.p21@direct.painphysicians.nextgenshare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness95
Years active:5State licenses:2Other names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for MS. TRISTA M GOTTWALT (MS, LADC)

  • 7400 France Ave S Ste 100

    Edina, MN 554354738

    Phone: (763) 537-6000

    Type: Location

  • 2104 NORTHDALE BLVD NW STE 220

    COON RAPIDS, MN 554333046

    Phone: (763) 537-6000

    Fax: (763) 537-6666

    Type: Mailing

  • 13313 DELORES DR

    PIERZ, MN 563644238

    Phone: (320) 360-1810

    Type: Mailing

  • 2140 NORTHDALE BLVD NW # 220

    COON RAPIDS, MN 554333005

    Phone: (763) 537-6000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240301000682IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55435)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769378942View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
-MN
Physical Therapist In Private PracticeMN
-MN
Anesthesiology, Interventional Pain ManagementMN
Physician AssistantMN
Family Practice, Pain ManagementMN
Nurse PractitionerMN
-MN
Physician AssistantMN

Reviews

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Frequently asked questions

How do I look up MS. TRISTA M GOTTWALT (MS, LADC) by NPI?
Use NPI 1184291049 when you need to reference MS. TRISTA M GOTTWALT (MS, LADC) in forms, claims, or directories.
Does this profile mean MS. TRISTA M GOTTWALT (MS, LADC) is currently active?
Yes — MS. TRISTA M GOTTWALT (MS, LADC) appears active in the national provider directory.
Can you summarize MS. TRISTA M GOTTWALT (MS, LADC)'s specialty in plain language?
Clinically, the directory lists MS. TRISTA M GOTTWALT (MS, LADC) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location shows for MS. TRISTA M GOTTWALT (MS, LADC)?
We surface Edina, Minnesota for MS. TRISTA M GOTTWALT (MS, LADC) based on available NPPES addresses.
How can I contact MS. TRISTA M GOTTWALT (MS, LADC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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