Gary T Renaldo, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

33559 Issued in NC

Practice address

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Phone

(336) 277-2000

Fax

(336) 277-2050

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Medical Park Hospital LLC

  • Specialist
  • Winston-Salem, NC
  • NPI 1003867516
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  • Hematology & Oncology Physician
  • Thomasville, NC
  • NPI 1013226307
  NPD
• Medical Park Hospital LLC

  • General Acute Care Hospital
  • Winston-Salem, NC
  • NPI 1538111828
  NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1932168663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "366-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENALDO",
        "first_name": "GARY",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "33559",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "33559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WSCA GRP NPI #",
            "identifier": "1285682310",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS ID#",
            "identifier": "757",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "71244",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932168663",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8971244",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grenaldo16592@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jared Rejeski, M.D.
• Jordan De Andrade Rejeski, M.D.
• Rejuvenation Support Services, Inc
• Relief Physical Therapy, LLC
• Remedy & Rise PLLC
• Mary Render
• Peggy Renegar, M.A., CCC-SLP
• Rebekah Renegar
• Renewed Power for Living Corp
• Rent a Bot

• Cardiovascular Disease Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.