NPIMap

Individual provider Active NPI

Juan Diego Baltodano, M.D.

  • Gastroenterology Physician
  • North Chesterfield, VA
National Provider Identifier
1861665945
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101243367 Issued in VA
Practice address
201 Wadsworth Dr
North Chesterfield, VA 23236-4510
Phone
(804) 289-1131
Fax
(804) 320-3102
NPI assigned
Apr 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101243367 VA Primary

Addresses

Primary practice location

201 Wadsworth Dr
North Chesterfield, VA 23236-4510

Mailing address

2369 Staples Mill Rd
Suite 200
Richmond, VA 23230-2909
Phone (804) 285-8206

Other identifiers 1

IdentifierTypeStateIssuer
1861665945MedicaidVA

Other names 1

  • Dr. Juan Diego Baltodano Parra Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130408000117 VA Practitioner - Gastroenterology 1759526114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Specialists LLCGroup PAC ID 5294797957, 79 clinicians

Practice addresses (Care Compare)

201 Wadsworth Dr
North Chesterfield, VA 23236-4510
Phone (804) 289-1131

6602 W Broad St
Suite B
Richmond, VA 23230-1702
Phone (804) 285-8206

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy84
Upper gastrointestinal (GI) endoscopy for acid reflux147

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243367VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialists LLC Gastroenterology CurrentSince Mar 18, 2013 Accepting new patients

Locations

8266 Atlee Rd
Ste 133
Mechanicsville, VA 23116
Phone (804) 730-0792

13700 St Francis Blvd
Ste 505
Midlothian, VA 23114
Phone (804) 423-3636

201 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 289-1131

215 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 497-4973

6602 W Broad St
#B
Richmond, VA 23230
Phone (804) 289-1137

1600 Wilkes Ridge Dr
Ste 100
Richmond, VA 23233
Phone (703) 563-0042

2369 Staples Mill Rd
Ste 100
Richmond, VA 23230
Phone (804) 354-8818

2369 Staples Mill Rd
Ste 200
Richmond, VA 23230
Phone (804) 285-4465

110 N Robinson St
Ste 100
Richmond, VA 23220
Phone (804) 254-5300

7611 Forest Ave
Ste 320
Richmond, VA 23229
Phone (804) 237-7950

1396 Tappahannock Blvd
#B
Tappahannock, VA 22560
Phone (804) 288-1953

Organizations & group practices 1

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1861665945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2369 STAPLES MILL RD",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302909",
            "telephone_number": "804-285-8206",
            "fax_number": "804-285-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WADSWORTH DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364510",
            "telephone_number": "804-289-1131",
            "fax_number": "804-320-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTODANO",
        "first_name": "JUAN DIEGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101243367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861665945",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN DIEGO",
            "last_name": "BALTODANO PARRA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.