Provider Demographics
NPI:1134168370
Name:GELPI, JUAN R (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:R
Last Name:GELPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-481-3820
Practice Address - Street 1:1120 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 203
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2418
Practice Address - Country:US
Practice Address - Phone:757-481-4424
Practice Address - Fax:757-481-3820
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054066174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
35085OtherOPTIMA HEALTH PLAN
VA007305842Medicaid
1700818OtherUNITED HEALTHCARE
257363OtherMAMSI
NC790511UMedicaid
020030341OtherRAILROAD MEDICARE
213137OtherCIGNA
5004137OtherAETNA
330539OtherANTHEM
9576463OtherGHI
1700818OtherUNITED HEALTHCARE
G28574Medicare UPIN
1700818OtherUNITED HEALTHCARE