LUIS GARDUNO – Internal Medicine Physician, NPI 1083364947
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
4,056 INTERNAL MEDICINE in WA
Provider Addresses for LUIS GARDUNO
901 Mountain View Dr
Shelton, WA 985844401
Phone: (360) 427-9549
Type: Location
1415 E Kincaid St
Mount Vernon, WA 982744126
Phone: (584) 631-6481
Type: Location
1415 E KINCAID ST
MOUNT VERNON, WA 982744126
Phone:
Type: Mailing
110 N LAVENTURE RD STE C
MOUNT VERNON, WA 982733901
Phone: (360) 814-8240
Fax: (360) 848-4502
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250722001680 | I | Internal Medicine | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98584)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Clinical Social Worker | WA | |
| Family Practice | WA | |
| - | WA | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| N E U R O L O G Y | MA | |
| Emergency Medicine | WA | |
| Physician Assistant | VA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WA | |
| Physician Assistant | WA |
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