Medicare Enrolled
Dr. Nicholas Gularte, DO
Physical Medicine & Rehabilitation · Napa, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Gularte from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Gularte
Dr. Nicholas Gularte is a physical medicine & rehabilitation specialist in Napa, CA, with 8 years of NPI registration. Based on federal Medicare data, Dr. Gularte performed 6,789 Medicare services across 3,256 unique beneficiaries.
Between the years covered by Open Payments, Dr. Gularte received a total of $551 from 10 pharmaceutical and/or device companies across 15 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in physical medicine & rehabilitation. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Gularte is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 8 years in practice
▲ Top 8% volume in CA
$551 industry payments
Medicare Practice Summary
Medicare Utilization ↗6,789
Medicare services
Top 8% in CA for physical medicine & rehabilitation
3,256
Unique beneficiaries
$51
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~849 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Steroid injection (triamcinolone) A 10 mg injection of triamcinolone acetonide, a corticosteroid medication. This code specifies the drug and dosage administered. |
1,786 | $1 | $18 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
1,627 | $72 | $233 |
| Dexamethasone injection (steroid) An injection of dexamethasone sodium phosphate, a corticosteroid medication, administered in a dose of 1 milligram. |
605 | $0 | $10 |
| Ultrasound-guided large joint aspiration or injection This procedure uses ultrasound imaging to guide the removal of fluid from or the injection of medication into a large joint. |
510 | $79 | $259 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
333 | $100 | $282 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
318 | $131 | $433 |
| Sacral spine nerve root injection with imaging guidance An injection of anesthetic and/or steroid medication into a sacral spine nerve root. The procedure uses imaging guidance to ensure accurate placement. |
209 | $96 | $594 |
| Additional sacral spine nerve root injection with imaging An injection of anesthetic and/or steroid medication into an additional sacral spine nerve root level, guided by imaging. |
120 | $43 | $139 |
| Spine facet joint injection with imaging guidance, single level An injection is administered into a single facet joint of the lower or sacral spine while using imaging guidance to ensure accurate placement. |
102 | $80 | $261 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
95 | $81 | $282 |
| Sedation by physician, initial 15 minutes Administration of a drug to induce depression of consciousness by the physician performing a procedure. This code covers the initial 15 minutes of sedation for patients aged 5 years or older. |
93 | $10 | $118 |
| Trigger point injection, 3 or more muscles Injection of medication into three or more specific muscle trigger points to relieve pain. |
92 | $50 | $174 |
| Telephone medical discussion, 5-10 minutes A phone conversation with a physician lasting between 5 and 10 minutes to discuss medical matters. |
87 | $45 | $77 |
| Facet joint injection, second level, with imaging guidance An injection into a lower or sacral spine facet joint using imaging guidance for the second level treated. |
79 | $44 | $132 |
| Limited ultrasound of joint or extremity A focused ultrasound exam of a specific joint or other structure in the arm or leg, excluding blood vessels. |
75 | $34 | $98 |
| Knee X-ray, 3 views An X-ray imaging test of the knee joint that captures three different angles to evaluate the bones and surrounding structures. |
73 | $32 | $110 |
| X-ray of lower and sacral spine, 2-3 views An X-ray imaging test that captures 2 to 3 views of the lower back and sacral spine to visualize the bones and joints in this area. |
63 | $31 | $98 |
| Physical therapy exercise, per 15 min A therapy session using exercises to improve strength, endurance, range of motion, and flexibility. Each 15-minute unit is billed separately. |
52 | $19 | $86 |
| Hip X-ray, 2-3 views An X-ray imaging test of the hip joint using two to three different angles to visualize the bones and surrounding structures. |
50 | $41 | $111 |
| Ultrasound guidance for needle placement Use of ultrasound imaging to guide the precise placement of a needle during a medical procedure. |
43 | $46 | $300 |
| Hyaluronan intra-articular injection An injection of hyaluronan or a derivative into a joint to provide lubrication and cushioning. |
41 | $560 | $2,117 |
| Trigger point injection, 1-2 muscles A procedure involving the injection of medication into one or two specific muscles to treat trigger points. |
38 | $44 | $151 |
| X-ray of lower and sacral spine, minimum of 4 views An X-ray imaging test of the lower back and sacrum using at least four different angles to visualize the bones and joints. |
38 | $45 | $133 |
| Shoulder X-ray, 2+ views An X-ray imaging test of the shoulder joint using at least two different angles to visualize the bones and surrounding structures. |
36 | $27 | $82 |
| Joint injection, major joint Removal of fluid from a large joint and/or injection of medication into the joint space. |
34 | $49 | $173 |
| Spinal injection with imaging guidance A procedure where medication is injected into the middle or upper part of the spinal canal. Imaging technology is used to guide the needle to the correct location. |
30 | $88 | $655 |
| Spinal and pelvic nerve injection with imaging guidance An anesthetic and/or steroid medication is injected into nerves in the spine or pelvis while using imaging to guide the needle placement. |
28 | $196 | $345 |
| Tendon or ligament injection A procedure involving the injection of medication into a tendon or ligament. |
24 | $45 | $199 |
| Facet joint nerve destruction, single joint A procedure to destroy nerves in a single lower or sacral spinal facet joint using imaging guidance to target pain signals. |
19 | $164 | $800 |
| X-ray of upper spine, 2-3 views An X-ray imaging test of the upper spine using two to three different angles to visualize the bones and structures. |
19 | $30 | $93 |
| Facet joint nerve destruction, additional joint This procedure uses imaging guidance to destroy nerves in an additional lower or sacral spinal facet joint. |
16 | $50 | $400 |
| X-ray of middle spine, 2 views An X-ray imaging test that produces two views of the middle section of the spine to visualize the bones and joints. |
16 | $28 | $85 |
| Injection into lower spine canal with imaging guidance A procedure where a substance is injected into the lower part of the spinal canal. The injection is performed using imaging guidance to ensure accurate placement. |
13 | $227 | $655 |
| Office visit, established patient (10-19 min) An office visit for an existing patient lasting 10 to 19 minutes. The visit involves medical evaluation and management of the patient's condition. |
13 | $41 | $115 |
| Limited needle EMG of arm or leg muscles A test that measures the electrical activity in specific muscles of the arm or leg using a needle electrode. This limited study evaluates muscle function in a targeted area. |
12 | $55 | $196 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Industry Payment Transparency
Open Payments through 2024 ↗$551
Total received (2019-2024)
Avg $92/year across 6 years
Top 39% in CA for physical medicine & rehabilitation
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
10
Companies
15
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$551 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$114
2023
$17
2022
$133
2021
$132
2020
$65
2019
$91
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Arthrex, Inc.
$83
Vertos Medical, Inc.
$31
Top 3 companies account for 100.0% of 2024 payments
All-time payments by company (2019-2024) ›
Vertos Medical, Inc.
$164
Arthrex, Inc.
$83
Merz North America, Inc.
$73
Merz Pharmaceuticals, LLC
$69
Lilly USA, LLC
$43
Medtronic USA, Inc.
$34
Amgen Inc.
$28
Teva Pharmaceuticals USA, Inc.
$21
Avanir Pharmaceuticals, Inc.
$20
Pacira Pharmaceuticals Incorporated
$17
Top 3 companies account for 57.9% of all-time payments
Associated products mentioned in payments ›
AJOVY · Aimovig · EMGALITY · Iovera · NUEDEXTA · SYNCHROMED · XEOMIN · Xeomin · mild Device Kit
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Physical medicine & rehabilitations within 10 mi
37
Per 100K population
27.2
County median income
$108,970
Nearest hospital
PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Gularte is a clinical cardiology specialist, with above-average Medicare volume (top 8% in CA), with low-engagement industry engagement.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Gularte experienced with steroid injection (triamcinolone)?
Based on Medicare claims data, Dr. Gularte performed 1,786 steroid injection (triamcinolone) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Gularte receive payments from pharmaceutical companies?
Yes. Dr. Gularte received a total of $551 from 10 companies across 15 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Gularte's costs compare to other physical medicine & rehabilitations in Napa?
Dr. Gularte's average Medicare payment per service is $51. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Gularte) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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