Individual provider Active NPI

Gary Michael Pugh, MPAS, PA-C, ATC

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1669685194
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004241 Issued in VA
Practice address
2800 Ivy Rd
Charlottesville, VA 22903
Phone
(434) 243-3600
Fax
(434) 244-4454
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126000653 VA
Physician Assistant 363A00000X 0110004241 VA Primary

Addresses

Primary practice location

2800 Ivy Rd
Charlottesville, VA 22903

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-0211

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000641 VA Practitioner - Physician Assistant 3072753078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1204 W Main St
Charlottesville, VA 22903-2824

1215 Lee St
Charlottesville, VA 22908-0816

2280 Ivy Rd
Charlottesville, VA 22903-4977

24 Gloucester Rd
Stuarts Draft, VA 24477-3321
Phone (540) 337-3710

250 Merchant Walk SQ
Suite 1103
Charlottesville, VA 22902-6511
Phone (434) 328-4900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0126000653VAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Oct 18, 2021 Accepting new patients
Rector & Visitors of the University of Virginia Past Accepting new patients

Locations

515 Ray C Hunt Dr
Ste 1100
Charlottesville, VA 22903
Phone (434) 243-7778

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

515 Ray C Hunt Dr
Charlottesvle, VA 22903
Phone (434) 244-2000

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

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.

Hospital & facility affiliations 4

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1669685194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 IVY RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "434-243-3600",
            "fax_number": "434-244-4454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MPAS, PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000653",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.