Miriam Elizabeth Gotthardt, P.A-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001817 Issued in VA

Practice address

611 Denbigh Blvd
Newport News, VA 23608-4415

Phone

(757) 283-8300

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Miriam Elizabeth Perez Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Richmond Medical Group PLLCGroup PAC ID 9931011434, 315 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vaexchange@patientfirstclinics.com

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.

• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748
  Medicare reassignment Care Compare group NPD
• Patient First Richmond Medical Group PLLC

  • Urgent Care Clinic/Center
  • Fairfax, VA
  • NPI 1588018881
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1033282918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700",
            "fax_number": "804-217-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 DENBIGH BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084415",
            "telephone_number": "757-283-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTHARDT",
        "first_name": "MIRIAM",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "611 Denbigh Blvd",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236084415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "PEREZ",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Savannah Gore
• Laura Gorenc, ED.S.
• Thomas Jamaar Gorham, QMHP-A
• Danielle Gorman, DPT
• Lee J Gotthardt, FNP-BC
• Kristen Noelle Goudreau, RBT
• Sarah Rotella Goujon, ACNP
• Aaron Glenn Gould, D.P.M.
• Jacqueline Gould
• Amanda Lyn Grab, FNP-C

• Physician Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.