NPIMap

Individual provider Active NPI

Albert Gordon Pavalonis, D.O.

  • Vascular Surgery Physician
  • Lynchburg, VA
National Provider Identifier
1326302563
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0102205543 Issued in VA
Practice address
2410 Atherholt Rd
Lynchburg, VA 24501-2148
Phone
(434) 200-5299
Fax
(434) 200-2386
NPI assigned
Jul 3, 2012
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0102205543 VA Primary

Addresses

Primary practice location

2410 Atherholt Rd
Lynchburg, VA 24501-2148

Mailing address

1735 Calais Trail
Powhatan, VA 23139-4523
Phone (540) 588-0521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180427000459 PA Practitioner - General Surgery 7911809603 Reassigns benefits to 1 organization
I20190806000411 VA Practitioner - Vascular SurgeryPractitioner - General Surgery 7911809603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1906 Thomson Dr
Lynchburg, VA 24501-1009
Phone (434) 200-3933

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Leg revascularization (restoring blood flow)54
Removal of tissue14
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Feb 13, 2018 Accepting new patients
Centra Medical Group, LLC CurrentSince Jul 15, 2019 Accepting new patients
Susquehanna Physician Services Surgery CurrentSince Feb 13, 2018 Accepting new patients

Locations

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

740 High St
Ste 1003
Williamsport, PA 17701
Phone (570) 321-3160

800 Oak St
Farmville, VA 23901
Phone (434) 315-2530

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1906 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-3933

1911 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-3901

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6484

2410 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-5252

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1326302563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 CALAIS TRAIL",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231394523",
            "telephone_number": "540-588-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012148",
            "telephone_number": "434-200-5299",
            "fax_number": "434-200-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVALONIS",
        "first_name": "ALBERT",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0102205543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.