Frank Gwathmey, M.D.
NPI 1528261229 · Sports Medicine (Orthopaedic Surgery) Physician · Charlottesville, VA
Enrolled with Medicare as Practitioner - Orthopedic Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Frank Gwathmey, M.D. is a Sports Medicine (Orthopaedic Surgery) Physician provider in Charlottesville, VA (NPI 1528261229).
Provider details
- NPI number
- 1528261229
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 0101027381 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
146 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 50 | $93 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 44 | $61 |
| Aspiration And/Or Injection of Fluid From Large Joint20610 | 25 | $43 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 14 | $128 |
| Repair of Shoulder Rotator Cuff Using an Endoscope29827 | 13 | $1,029 |
Typical Medicare-allowed amounts for these services range $43–$1,029 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$5,677 across 22 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (1)
- 1215 Lee StCharlottesville, VA 22908-0816Phone: (434) 924-0211
Registry dates
- Enumerated
- 2007-06-08
- Last updated
- 2023-08-09
- Certified
- 2023-08-09
Frequently asked questions
- What is Frank Gwathmey's NPI number?
- Frank Gwathmey's National Provider Identifier (NPI) is 1528261229, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Frank Gwathmey's specialty?
- Frank Gwathmey is listed in the NPPES registry with a primary specialty of Sports Medicine (Orthopaedic Surgery) Physician (Allopathic & Osteopathic Physicians).
- Where is Frank Gwathmey located?
- Frank Gwathmey's practice location on file with NPPES is 2800 Ivy Rd, Charlottesville, VA 22903.
- What is Frank Gwathmey's phone number?
- The practice phone number listed in the NPPES registry for Frank Gwathmey is (434) 243-3600.
- Does Frank Gwathmey accept Medicare?
- Frank Gwathmey is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Frank Gwathmey's NPI active?
- Yes — Frank Gwathmey's NPI (1528261229) is active in the NPPES registry as of the last update on 2023-08-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.