Louis Paul Gualdoni, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110840653 Issued in VA

Practice address

1802 Braeburn Dr
Suite 1310
Salem, VA 24153-7357

Phone

(540) 776-2020

Fax

(540) 776-2017

NPI assigned

Nov 16, 2005

Last updated

Apr 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Cardiothoracic Surgeons of Roanoke Valley LLC

  dba Cardiothoracic Surgeons of Roanoke Valley

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Salem, VA
  • NPI 1346343563
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1518949544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277730",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847730",
            "telephone_number": "615-373-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "address_2": "SUITE 1310",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-776-2020",
            "fax_number": "540-776-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUALDONI",
        "first_name": "LOUIS",
        "middle_name": "PAUL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110840653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00453910",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010400856",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Paul Gross, M.D.
• Theresa Grossheim
• Lucian Y Grove Jr., M.D.
• Tammy Herring Grove, MS,CCC
• Leena S Grover, M.D.
• Jonathan Alan Gudeman, O.D.
• Albert Harlen Gudger Jr., KT
• Maureen G Guelzow, LPC
• Sara Guerry, LCSW
• Amy L Guilliams, LICENSED PHYSICAL TH

• Surgical Physician Assistant in Salem, VA
• Providers in Salem, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.