Jonathan Alan Gudeman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000618 Issued in VA

Practice address

101 W 4TH St
Salem, VA 24153-3638

Phone

(540) 387-1183

NPI assigned

Sep 12, 2005

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 4

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Salem, IncGroup PAC ID 4688683741, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgudeman@invisionsalem.eyefinity-direct.com

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.

• Eyecare Salem, Inc

  • Optometrist
  • Salem, VA
  • NPI 1073545539
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1760477228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 4TH ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533638",
            "telephone_number": "540-387-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 4TH ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533638",
            "telephone_number": "540-387-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDEMAN",
        "first_name": "JONATHAN",
        "middle_name": "ALAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "461361",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "410049826",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9237216",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR FEDERAL",
            "identifier": "4715110001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Grossheim
• Lucian Y Grove Jr., M.D.
• Tammy Herring Grove, MS,CCC
• Leena S Grover, M.D.
• Louis Paul Gualdoni, PAC
• Albert Harlen Gudger Jr., KT
• Maureen G Guelzow, LPC
• Sara Guerry, LCSW
• Amy L Guilliams, LICENSED PHYSICAL TH
• Paige Barksdale Guilliams, FNP-C

• Optometrist in Salem, VA
• Providers in Salem, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.

Verify at the official NPI Registry.