MARTHA FLYE PLUMER GAULT, RN — NPI 1790248490 (Licensed & Credentialed Registered Nurse, Rehabilitation in CANANDAIGUA, NY)

CMS-1500 Box 24J / 33a • NPI

1790248490

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163WR0400X

Licensed & Credentialed Registered Nurse, Rehabilitation

Box 32 Service Location & ZIP+4

400 FORT HILL AVE, CANANDAIGUA, NY, 14424-1159

✓ 9-Digit EDI 837 ZIP+4 (14424-1159)

Practice Phone & Referral Fax

(585) 394-2000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790248490 (MARTHA FLYE PLUMER GAULT, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1790248490` (NPI-1 Individual Practitioner)
Provider / Legal Name	MARTHA FLYE PLUMER GAULT, RN
Plain-English Specialty	Licensed & Credentialed Registered Nurse, Rehabilitation NUCC Code: `163WR0400X` (Registered Nurse, Rehabilitation)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	400 FORT HILL AVE, CANANDAIGUA, NY, 14424-1159
Practice Telephone / Fax	Tel: (585) 394-2000
Administrative Mailing Address	PO BOX 35, ROSEBUD, SD, 57570-0035
Enumeration & Last Sync	Enumerated: 2019-04-09 \| CMS Record Updated: 2019-04-09

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

400 FORT HILL AVE, CANANDAIGUA, NY, 14424-1159

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Plain-English Taxonomy & CMS Crosswalk (163WR0400X)

What Does Taxonomy Code 163WR0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WR0400X translates to:
"Licensed & Credentialed Registered Nurse, Rehabilitation"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Registered Nurse, Rehabilitation for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARTHA FLYE PLUMER GAULT, RN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163WR0400X` — Registered Nurse, Rehabilitation Plain English: Licensed & Credentialed Registered Nurse, Rehabilitation	State: SD \| License: `R048372` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MARTHA FLYE PLUMER GAULT, RN (NPI #1790248490)