Alyssa Shanks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110009281 Issued in VA

Practice address

500 J Clyde Morris Blvd FL Annex1
Newport News, VA 23601-1929

Phone

(757) 594-3369

NPI assigned

Aug 19, 2017

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

• Alyssa Fultz Former name

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
• Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
• Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Merit-based Incentive Payment System (MIPS)

Final score

94.91 of 100Reported as apm

Quality

92.86

Promoting interoperability

94.93

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashanks216658@direct.rivhs.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.

• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment Care Compare group
• The Little Clinic of Tennessee LLC

  • Family Nurse Practitioner
  • White House, TN
  • NPI 1487848800
  Medicare reassignment
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services Inc

  • Cardiovascular Disease Physician
  • Smithfield, VA
  • NPI 1306383781
  NPD

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

• Doctors' Hospital of Williamsburg

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1275893307
  Care Compare affiliation
• Riverside Hospital Inc

  • General Acute Care Hospital
  • Smithfield, VA
  • NPI 1366259863
  Care Compare affiliation
• Riverside Hospital Inc

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation
• Riverside Middle Peninsula Hospital Inc

  • General Acute Care Hospital
  • Gloucester, VA
  • NPI 1528162534
  Care Compare affiliation
• 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": "1503100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1033635297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD FL ANNEX1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-3369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11803 Jefferson Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064390",
            "country_code": "US",
            "telephone_number": "757-873-0360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Enterprise Pkwy Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236666251",
            "country_code": "US",
            "telephone_number": "757-827-7754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-19",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "FULTZ",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louis Shepherd Seyler, L.C.S.W.
• Thomas J. Shacochis, MD
• Kindra Shafer, FNP
• Parin R Shah, D.O.
• Sufia B Shahid, MD
• Austin Drennan Shanks, MD
• Shannon M Martin
• Robert Allan Shapiro, O.D.
• Roni Sharon, M.D.
• Jennifer L Sharp-Warthan, M.D.

• 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 Aug 2, 2023; 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.