Individual provider Active NPI

Gregory Wiaterek, MD

  • Pulmonary Disease Physician
  • Charlottesville, VA
National Provider Identifier
1255538633
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101248807 Issued in VA
Practice address
500 Martha Jefferson Dr FL 5
Charlottesville, VA 22911
Phone
(434) 654-5260
Fax
(434) 654-5261
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101248807 VA
Pulmonary Disease Physician 207RP1001X 0101248807 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr FL 5
Charlottesville, VA 22911

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Other practice location 1

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-7580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000001 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 6305023441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-8960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Critical Care Medicine CurrentSince May 2, 2017 Accepting new patients
Martha Jefferson Hospital PastSince May 2, 2017 Accepting new patients

Locations

500 Martha Jefferson Dr
#505
Charlottesville, VA 22911

500 Martha Jefferson Dr
Ste 415C
Charlottesville, VA 22911
Phone (434) 654-8960

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1255538633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR FL 5",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22911",
            "telephone_number": "434-654-5260",
            "fax_number": "434-654-5261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Martha Jefferson Dr",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229114668",
            "country_code": "US",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIATEREK",
        "first_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101248807",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101248807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.