Active NPI
Ulfur T Gudjonsson, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Fort Wayne, IN
National Provider Identifier
1467656926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 0452599
- Practice address
- 7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160 - Phone
- (260) 435-7001
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 01070481A | IN | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | C5709 | KY | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | ME126528 | FL | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 0452599 | KS | Primary |
Addresses
Primary practice location
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other practice location 1
1532 Lone Oak Rd Ste 445
Paducah, KY 42003-7943
Phone (270) 538-5830
Other practice location 2
2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 625-4699
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017214900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MO, KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600
1723 Broadway St
Suite 210
Cape Girardeau, MO 63701-4556
Phone (537) 331-7841
7910 W Jefferson Blvd
Suite 102
Fort Wayne, IN 46804-4159
Phone (260) 436-2424
Hospital & facility affiliations
- Mercy Hospital Springfield
- Lutheran Hospital of Indiana
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 14 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Southeast Missouri Hospital Physicians, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Current | Accepting new patients |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Heart Surgery Center | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past | Accepting new patients |
Locations
1723 Broadway St
Ste 210
Cape Girardeau, MO 63701
Phone (573) 331-7840
1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Cape Girardeau, MO
- NPI 1558311522
Thoracic Surgery (Cardiothoracic Vascular Surgery)
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1164662805
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Surgery Physician
- Salina, KS
- NPI 1619952785
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Tallahassee, FL
- NPI 1861402711
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1467656926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044160",
"telephone_number": "260-435-7001"
}
],
"practiceLocations": [
{
"address_1": "1532 Lone Oak Rd Ste 445",
"address_purpose": "LOCATION",
"city": "Paducah",
"state": "KY",
"postal_code": "420037943",
"country_code": "US",
"telephone_number": "270-538-5830",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2220 Canterbury Dr",
"address_purpose": "LOCATION",
"city": "Hays",
"state": "KS",
"postal_code": "676012370",
"country_code": "US",
"telephone_number": "785-625-4699",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUDJONSSON",
"first_name": "ULFUR",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "IN",
"license": "01070481A",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "KY",
"license": "C5709",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "FL",
"license": "ME126528",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "KS",
"license": "0452599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017214900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.