Nathan Guerette, MD
Urogynecology and Reconstructive Pelvic Surgery · Midlothian, VANPI 1942230040
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (32.9%), consulting fees and food and beverage — rather than concentrated in one kind of arrangement. 20 manufacturers reported payments, led by Coloplast at 32.8% of the total. Reporting peaked in 2021 at $12,876 and has fallen 97.3% since, to $345 in 2025.
Across 122 payments — averaging $161.18 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Coloplast$6K
- Caldera Medical, Inc$6K
- Intuitive Surgical$3K
- Momentis Surgical Inc.$1K
- Medtronic$873
- AbbVie$719
- plus $1K from 14 others
Across 9 payments — averaging $914.72 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Boston Scientific$8K
What the payments were for
- Consulting fees$5,62029%
- Travel & lodging$3,33917%
- Food & beverage$4,23022%
- Education$6,46033%
- Gifts$150%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Coloplast | 4 | $6,454 |
| Caldera Medical, Inc | 5 | $5,796 |
| Intuitive Surgical | 14 | $3,403 |
| Momentis Surgical Inc. | 4 | $1,094 |
| Medtronic(2 entities) | 20 | $873 |
| AbbVie(2 entities) | 29 | $719 |
| Axonics, Inc. | 11 | $505 |
| Boston Scientific | 3 | $197 |
| Astellas Pharma US Inc | 10 | $170 |
| Pfizer | 6 | $98 |
| Therapeuticsmd, Inc. | 4 | $61 |
| AMAG Pharmaceuticals, Inc. | 3 | $60 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $56 |
| Community Blood Center | 1 | $35 |
| Myovant Sciences Inc. | 2 | $35 |
| Johnson & Johnson | 1 | $34 |
| Laborie Medical Technologies Corp. | 1 | $28 |
| Provepharm Inc. | 1 | $19 |
| Coopersurgical, Inc. | 1 | $14 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $14 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- ALTIS$6,400
- Desara$5,741
- Da Vinci Surgical System$3,147
- Anovo Surgical System$959
- INTERSTIM$147
- UPSYLON$138
- Bulkamid$112
How this compares
$19,664 in reported general payments places this provider in the 85th percentile of 29 urogynecology and reconstructive pelvic surgery providers in Virginia.
See all urogynecology and reconstructive pelvic surgery providers in Virginia →
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| MyrbetriqMirabegron | 11 | $8,190 |
| Estradiol | 76 | $4,909 |
| Nitrofurantoin Mono-MacroNitrofurantoin Monohyd/M-Cryst | 250 | $3,121 |
| Lactulose | 24 | $415 |
| Nystatin | 21 | $397 |
| Baclofen | 32 | $395 |
| Doxycycline Monohydrate | 49 | $339 |
| Clobetasol Propionate | 17 | $309 |
| Ciprofloxacin Hcl | 59 | $289 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 45 | $255 |
| Fluconazole | 42 | $201 |
| Metronidazole | 25 | $199 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 26 | $192 |
| Cephalexin | 46 | $141 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 40 | $112 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Astellas Pharma US IncMyrbetriq | $170 | $8,19011 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 85th percentile of 29 urogynecology and reconstructive pelvic surgery providers in Virginia.
Other urogynecology and reconstructive pelvic surgery in Midlothian
- Seyed ShobeiriFalls Church$116K
- Kurt McCammonVirginia Beach$67K
- Jeffrey WelgossAnnandale$50K
- Eric ChangStafford$11K
- Patricia MwesigwaArlington$8K
- Anna TrikhachevaPortsmouth$6K
- Walter von PechmannAnnandale$6K
- Mary BurnsViriginia Beach$6K
- Meghana GowdaRichmond$5K
- Nina DereskaRoanoke$5K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.