Individual provider Active NPI

Colleen Rita Quick, PA-C

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1043093230
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009692 Issued in VA
Practice address
612 Kingsborough SQ Ste 100
Chesapeake, VA 23320-5041
Phone
(757) 547-9294
Fax
(757) 213-9342
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1210557 NY
Physician Assistant 363A00000X 0110009692 VA Primary

Addresses

Primary practice location

612 Kingsborough SQ Ste 100
Chesapeake, VA 23320-5041

Mailing address

612 Kingsborough SQ Ste 100
Chesapeake, VA 23320-5041
Phone (757) 547-9294

Other practice location 1

1708 Old Donation Pkwy
Virginia Beach, VA 23454-3064
Phone (757) 419-3000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231220003889 VA Practitioner - Physician Assistant 5092165787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

1708 Old Donation Pkwy
Virginia Beach, VA 23454-3064
Phone (757) 419-3000

612 Kingsborough SQ
Suite 100
Chesapeake, VA 23320-5041
Phone (757) 547-9294

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1210557NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Dec 11, 2023 Accepting new patients
Bayview Physician Services, PC CurrentSince Dec 11, 2023 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients

Locations

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

612 Kingsborough Sq
Ste 100
Chesapeake, VA 23320
Phone (757) 547-9294

2000 Meade Pkwy
Ste 410
Suffolk, VA 23434

2075 Glenn Mitchell Dr
Ste 300
Virginia Beach, VA 23456
Phone (757) 821-2825

1708 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 395-5300

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1043093230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 KINGSBOROUGH SQ STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205041",
            "telephone_number": "757-547-9294",
            "fax_number": "757-213-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 KINGSBOROUGH SQ STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205041",
            "telephone_number": "757-547-9294",
            "fax_number": "757-213-9342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Old Donation Pkwy",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234543064",
            "country_code": "US",
            "telephone_number": "757-419-3000",
            "fax_number": "757-213-9377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUICK",
        "first_name": "COLLEEN",
        "middle_name": "RITA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1210557",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.