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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHAEL L GWALTNEY MD
NPI 1386802015
Pediatrics in Fishersville, VA

Active since May 29, 2008PECOS Enrolled
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939(540) 932-4075(540) 932-5199 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2026, Sep 23, 2024, Feb 27, 2021 and 5 more (8 updates tracked since 2020).

About Michael L Gwaltney Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL L GWALTNEY MD (NPI 1386802015) is an individual pediatrics provider in Fishersville, Virginia, licensed in Virginia (0101249737) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1386802015
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMICHAEL L GWALTNEYCredential: MD
Location Address78 MEDICAL CENTER DRFishersville, VA 22939-2332
Mailing AddressPo Box 388Fishersville, VA 22939-0388 · (540) 932-5162 · Fax (540) 932-5875
Phone(540) 932-4075
Fax(540) 932-5199
Sole ProprietorNo
Enumeration DateMay 29, 2008
Last NPPES UpdateSeptember 29, 20268 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2026
✔ NPI 1386802015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in VA · 0101249737
Definition
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.
78 MEDICAL CENTER DR, Fishersville, VA 22939
Open in Google Maps ↗

Secondary Practice Locations 5

Location 11840 Amherst StWinchester, VA 22601-2808 · Phone (540) 536-8000 · Fax (540) 836-3286
Location 23300 Gallows RdFalls Church, VA 22042-3300 · Phone (703) 776-4001 · Fax (703) 776-7113
Location 31204 W Main StCharlottesville, VA 22903-2824 · Phone (434) 924-5321
Location 457 Beam Ln Ste 202Fishersville, VA 22939-2350 · Phone (540) 332-5373 · Fax (540) 932-5382
Location 51215 Lee StCharlottesville, VA 22908-2332 · Phone (434) 924-5321

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael L Gwaltney Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Michael Gwaltney reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Virginia Physicians Group
26 mi
Neuromusculoskeletal Medicine, Sports Medicine
4105 LEWIS AND CLARK DR
Charlottesville, VA 22911
  • Reassigned Medicare billing, Virginia enrollment
  • 2,820 clinicians in this Medicare group
NPI 1033138250 (434) 295-1000
Adfinitas Health At Fauquier, LLC
77 mi
Hospitalist
500 HOSPITAL DR
Warrenton, VA 20186
  • Reassigned Medicare billing, Virginia enrollment
  • 55 clinicians in this Medicare group
NPI 1225558109 (443) 949-0814
Winchester Medical Center
86 mi
Family Medicine
230 COSTELLO DR STE B
Winchester, VA 22602
  • Reassigned Medicare billing, Virginia enrollment
  • 756 clinicians in this Medicare group
NPI 1356153415 (540) 536-5400
Inova Health Care Services
109 mi
Urgent Care
100 MAPLE AVE E
Vienna, VA 22180
  • Reassigned Medicare billing, Virginia and District of Columbia enrollments
  • Also billed through NPI 1952320061 (District of Columbia)
  • 2,379 clinicians in this Medicare group
NPI 1275886418 (703) 938-5300
Mdics At Calvert LLC
134 mi
Hospitalist
100 HOSPITAL RD
Prince Frederick, MD 20678
  • Reassigned Medicare billing, Maryland enrollment
  • 71 clinicians in this Medicare group
NPI 1033404207 (443) 949-0814

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22939 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NATHAN LEE MAUST MD
Emergency Medicine
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 332-4000
SARAH HA DO
Student in an Organized Health Care Education/Training Program
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 932-5595
LEWIS ALAN SIEGEL M.D.
Internal Medicine (Interventional Cardiology)
78 MEDICAL CENTER DR, HEART & VASCULAR CENTER, 2ND FLR
FISHERSVILLE, VA 22939
Augusta County (540) 245-7080
BARRY HOWARD BLUMENTHAL MD
Psychiatry & Neurology (Psychiatry)
78 MEDICAL CENTER DR, CROSSROADS
FISHERSVILLE, VA 22939
Augusta County (540) 213-2525
ANASTASIA SNELLING D.O.
Hospitalist
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 932-4075
AHEEMA GAZI D.O.
Student in an Organized Health Care Education/Training Program
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 245-7987
LAURA L FITZPATRICK MD
Anesthesiology
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 332-5757
KATHERINE A. BLACK M.D.
Anesthesiology
78 MEDICAL CENTER DR
FISHERSVILLE, VA 22939
Augusta County (540) 332-5757

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Gwaltney's NPI number?

The NPI number for Michael Gwaltney is 1386802015. It was assigned to this individual provider in the NPPES registry on May 29, 2008.

Where is Michael Gwaltney located?

Michael Gwaltney practices at 78 Medical Center Dr, Fishersville, VA 22939. The listed phone number is (540) 932-4075.

What is Michael Gwaltney's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Michael Gwaltney enrolled in Medicare?

Yes. Michael Gwaltney is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Michael Gwaltney's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Gwaltney reassigns Medicare benefits to 5 organizations: University Of Virginia Physicians Group (Charlottesville, VA), Adfinitas Health At Fauquier, LLC (Warrenton, VA), Winchester Medical Center (Winchester, VA), Inova Health Care Services (Vienna, VA) and Mdics At Calvert LLC (Prince Frederick, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Gwaltney's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Gwaltney accept?

Health plans from CareSource and Oscar Health list Michael Gwaltney as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Gwaltney was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.