WILLIAM RONALD GAERTNER M.D
NPI 1649267188
Psychiatry & Neurology - Psychiatry in Fredericksburg, VA
NPI Status: Active since September 30, 2005
Contact Information
621 JEFFERSON DAVIS HWY
SUITE 201
FREDERICKSBURG, VA
ZIP 22401
Phone: (540) 372-2028
Fax: (540) 372-6541
- Individual
- Male
- Psychiatry & Neurology
- Psychiatry
- Accepts Insurance
- PECOS Enrolled
About WILLIAM GAERTNER
This page provides the complete NPI Profile along with additional information for William Gaertner, a provider established in Fredericksburg, Virginia with a medical specialization in Psychiatry & Neurology, focusing in psychiatry . The healthcare provider is registered in the NPI registry with number 1649267188 assigned on September 2005. The practitioner's primary taxonomy code is 2084P0800X with license number 0101035045 (VA). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1649267188
- Provider Name
- WILLIAM RONALD GAERTNER M.D
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 621 JEFFERSON DAVIS HWY SUITE 201 FREDERICKSBURG, VA 22401
- Location Phone
- (540) 372-2028
- Location Fax
- (540) 372-6541
- Mailing Address
- 621 EMANCIPATION HWY STE 201 FREDERICKSBURG, VA 22401
- Mailing Phone
- (540) 372-2028
- Mailing Fax
- (540) 372-6541
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-30-2005
- Last Update Date
- 05-25-2022
- Code Navigator
A psychiatrist like William Gaertner are primary mental health physicians diagnose and treat mental illnesses through psychotherapy, psychoanalysis, hospitalization and medication. Psychiatrist help patients find solutions through changes in their behavioral patterns, explorations of experiences, group and family therapy.
Location Map
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
Psychiatry & Neurology Psychiatry
- Taxonomy Code
- 2084P0800X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 0101035045
- License State
- VA
- Taxonomy Description
- A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084A0401X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 0101035045 (VA) |
| 2 | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 0101035045 (VA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 146004 | OTHER (01) | ANTHEM | |
| 347 | OTHER (01) | VALUE OPTIONS | |
| 071985427 | MEDICAID (05) | VA | |
| 458104000 | OTHER (01) | MAGELLAN | |
| 51337 | OTHER (01) | CIGNA | |
| 081522 | OTHER (01) | OPTIMA | |
| 861112647 | OTHER (01) | UBH | |
| 4076171 | OTHER (01) | AETNA | |
| 307350 | OTHER (01) | ANTHEM |
Medicare Participation & PECOS Enrollment Status
William Gaertner 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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Hospital discharge day management, more than 30 minutes
Initial hospital inpatient care per day, typically 50 minutes
Psychiatric diagnostic evaluation with medical services
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 76 times for 35 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 81 times for 59 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 361 times for 57 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 32 times for 25 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 43 times for 39 patientsA psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
This service was performed 17 times for 16 patientsPhysician 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 22401 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $170.3
- Minimum New Patient Price $56.19
- Maximum New Patient Price $170.3
- Average New Patient Copayment $42.57
- 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 99213
- Average Established Patient Price $70.08
- Minimum Established Patient Price $18.07
- Maximum Established Patient Price $138.91
- Average Established Patient Copayment $17.52
- 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1649267188, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
FREDERICKSBURG, VA 22401
FREDERICKSBURG, VA 22401
FREDERICKSBURG, VA 22401
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1649267188, enumerated as an "individual" on September 30, 2005.
The provider is located at 621 JEFFERSON DAVIS HWY SUITE 201 FREDERICKSBURG, VA 22401 and the phone number is (540) 372-2028.
Psychiatry & Neurology with taxonomy code 2084P0800X and a focus in Psychiatry.
The provider might be accepting Accepts: Providence Health Plan, Anthem Blue Cross,. Please consult your insurance carrier or call the provider to verify.
