Individual provider Active NPI

Gregory S. Pudhorodsky, M.D.

  • Rheumatology Physician
  • Charlottesville, VA
National Provider Identifier
1962470658
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
0101040630 Issued in VA
Practice address
650 Peter Jefferson Pkwy
Ste 190
Charlottesville, VA 22911-8844
Phone
(434) 296-6161
Fax
(434) 296-6538
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101040630 VA
Rheumatology Physician 207RR0500X 0101040630 VA Primary

Addresses

Primary practice location

650 Peter Jefferson Pkwy
Ste 190
Charlottesville, VA 22911-8844

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101040630VAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Arthritis Associates Specialist Current Accepting new patients
University of Virginia Physicians Group PastSince Jun 29, 2016 Accepting new patients
Martha Jefferson Hospital Past Accepting new patients
Rector & Visitors of the University of Virginia Past Accepting new patients

Locations

1410 Incarnation Dr
Ste 205
Charlottesvle, VA 22901
Phone (434) 296-6161

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1962470658",
    "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": "650 PETER JEFFERSON PKWY",
            "address_2": "STE 190",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118844",
            "telephone_number": "434-296-6161",
            "fax_number": "434-296-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUDHORODSKY",
        "first_name": "GREGORY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101040630",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101040630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.