Individual provider Active NPI

Louis Robert Gualtieri, DO

  • Diagnostic Radiology Physician
  • Somers Point, NJ
National Provider Identifier
1265540397
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MB04673700 Issued in NJ
Practice address
30 E Maryland Ave
Somers Point, NJ 08244-2451
Phone
(609) 677-9729
Fax
(609) 652-6270
NPI assigned
Aug 28, 2006
Last updated
Nov 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MB04673700 NJ Primary

Addresses

Primary practice location

30 E Maryland Ave
Somers Point, NJ 08244-2451

Mailing address

72 W Jimmie Leeds Rd
Suite 1100
Galloway, NJ 08205-9406
Phone (609) 677-9729

Other identifiers 4

IdentifierTypeStateIssuer
P00758325OtherNJRAILROAD MEDICARE
2065401MedicaidNJ
P00236403OtherNJRAILROAD MEDICARE
P00847782OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040304000091 NJ Practitioner - Diagnostic Radiology 2668369547 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as group
Quality
98.86
Improvement activities
40
Cost
77.42

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
84.68
Improvement activities
40
Cost
71.47

Merit-based Incentive Payment System (MIPS)

Final score
91.1 of 100Reported as group
Quality
89.53
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ami Atlanticare LLC CurrentSince Aug 27, 2009 Accepting new patients
Atlantic Medical Imaging CurrentSince Jul 1, 2005 Accepting new patients
Atlantic Radiologists Professional Association LLC Diagnostic Radiology CurrentSince Apr 29, 2009 Accepting new patients
Atlantic Radiologist PA Diagnostic Radiology Past Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

44 E Jimmie Leeds Rd
Ste 101
Galloway, NJ 08205
Phone (609) 652-7349

72 W Jimmie Leeds Rd
Ste 1100
Galloway, NJ 08205
Phone (609) 652-6815

219 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 878-9729

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

30 E Maryland Ave
Somers Point, NJ 08244
Phone (609) 653-0209

401 Bethel Rd
Somers Point, NJ 08244
Phone (609) 356-6200

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1265540397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 W JIMMIE LEEDS RD",
            "address_2": "SUITE 1100",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059406",
            "telephone_number": "609-677-9729",
            "fax_number": "609-652-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E MARYLAND AVE",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442451",
            "telephone_number": "609-677-9729",
            "fax_number": "609-652-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUALTIERI",
        "first_name": "LOUIS",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MB04673700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00758325",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065401",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00236403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00847782",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

Verify at the official NPI Registry.