Individual provider Active NPI

Gregory S. Gelburd, DO

  • Family Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1417994146
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102036993 Issued in VA
Practice address
310 Avon St
Suite 9
Charlottesville, VA 22902-5750
Phone
(434) 817-1818
Fax
(434) 817-9606
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102036993 VA Primary

Addresses

Primary practice location

310 Avon St
Suite 9
Charlottesville, VA 22902-5750

Mailing address

PO Box 1583
Charlottesville, VA 22902-1583
Phone (434) 654-7794

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
I20111117000675 VA Practitioner - Family Practice 1557539863 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jul 5, 2020 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Jul 5, 2020 Accepting new patients

Locations

310 Avon St
Ste 9
Charlottesvle, VA 22902
Phone (434) 817-1818

8644 Sudley Rd
#220
Manassas, VA 20110

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1417994146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229021583",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 AVON ST",
            "address_2": "SUITE 9",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025750",
            "telephone_number": "434-817-1818",
            "fax_number": "434-817-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELBURD",
        "first_name": "GREGORY",
        "middle_name": "S.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102036993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.