Steven M Gualdoni, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001259 Issued in MI

Practice address

1414 W Fair Ave
Ste 332
Marquette, MI 49855-2675

Phone

(906) 225-3922

Fax

(906) 225-4527

NPI assigned

Sep 9, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DLP Marquette Physician Practices Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Physician Assistant

  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1003800640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 332",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3922",
            "fax_number": "906-225-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 332",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3922",
            "fax_number": "906-225-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUALDONI",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00231915",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephane Grijseels, MD
• Grisham Services Inc.
• Fred L Groos, MD
• Brandon Patrick Gross, LLMSW
• Michelle Grunert, LMSW
• Courtney Guidebeck, LMSW
• David Edward Guinn, NP
• Nidhi Azad Gupta, MD
• Pratap C Gupta, MD
• Tonya Gustafson

• Physician Assistant in Marquette, MI
• Providers in Marquette, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.