MICHAEL L GWALTNEY MD
NPI 1386802015
Pediatrics in Fishersville, VA

NPI Status: Active since May 29, 2008

Contact Information

78 MEDICAL CENTER DR
FISHERSVILLE, VA
ZIP 22939
Phone: (540) 932-4075
Fax: (540) 932-5199

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

Individual
Male
Pediatrics
Accepts Insurance
PECOS Enrolled

About MICHAEL GWALTNEY

This page provides the complete NPI Profile along with additional information for Michael Gwaltney, a pediatrician established in Fishersville, Virginia with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1386802015 assigned on May 2008. The practitioner's primary taxonomy code is 208000000X with license number 0101249737 (VA). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI: 1386802015
Provider Name: MICHAEL L GWALTNEY MD
Gender: Male
Entity Type: Individual
Location Address: 78 MEDICAL CENTER DR FISHERSVILLE, VA 22939
Location Phone: (540) 932-4075
Location Fax: (540) 932-5199
Mailing Address: PO BOX 388 FISHERSVILLE, VA 22939
Mailing Phone: (540) 932-5162
Mailing Fax: (540) 932-5199
Is Sole Proprietor?: No
Enumeration Date: 05-29-2008
Last Update Date: 09-23-2024
Code Navigator

A pediatrician like Michael Gwaltney is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Secondary Locations

1840 Amherst St
Winchester, VA 22601
(540) 536-8000
57 Beam Ln Ste 202
Fishersville, VA 22939
(540) 332-5373
3300 Gallows Rd
Falls Church, VA 22042
(703) 776-4001
1840 Amherst St
Winchester, VA 22601
(540) 536-8000
1215 Lee St
Charlottesville, VA 22908
(434) 924-5321
1204 W Main St
Charlottesville, VA 22903
(434) 924-5321

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: Pediatrics
Taxonomy Code: 208000000X
Type: Allopathic & Osteopathic Physicians
License No.: 0101249737
License State: VA
Taxonomy Description: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

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

CareSource

Bronze First 7500 $25 Generic Drugs - HMO
Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Gold 1500 $15 Generic Drugs - HMO
Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
Low Deductible Silver 4500 $3 Generic Drugs - HMO
Low Deductible Silver 4500 $3 Generic Drugs Adult Vision & Fitness - HMO
Low Premium Silver 6000 $3 Generic Drugs - HMO
Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
Platinum Zero $5 Generic Drugs - HMO
Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
Silver 5000 $20 Generic Drugs - HMO
Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO

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

Medicare Participation & PECOS Enrollment Status

Michael Gwaltney is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

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.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 22939 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $86.88
Minimum New Patient Price $56.19
Maximum New Patient Price $170.3

Average New Patient Copayment $21.72
Minimum New Patient Copayment $14.04
Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $99.13
Minimum Established Patient Price $18.07
Maximum Established Patient Price $138.91

Average Established Patient Copayment $24.78
Minimum Established Patient Copayment $4.51
Maximum Established Patient Copayment $34.72

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	3	8	6	8	0	2	0	1	5
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	16	6	16	0	4	0	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 6 + 6 + 1 + 6 + 0 + 4 + 0 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 5									5

The NPI number 1386802015 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. TIMOTHY J NITZSCHE MD

Anesthesiology

78 MEDICAL CENTER DR
ANESTHESIA DEPT
FISHERSVILLE, VA
ZIP 22939

About MICHAEL GWALTNEY

Location Map

Secondary Locations

Specialty - Primary Taxonomy

Pediatrics

Insurance Plans Accepted

CareSource

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for MICHAEL L GWALTNEY MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is Michael Gwaltney's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Michael Gwaltney accept?