John Christian Conrad Jr., P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110003758 Issued in VA

Practice address

4064 Postal Dr
Roanoke, VA 24018-6438

Phone

(540) 725-1226

Fax

(540) 857-5306

NPI assigned

Feb 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

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

Jefferson Medical College of Thomas Jefferson University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048

Merit-based Incentive Payment System (MIPS)

Final score

82.67 of 100Reported as group

Quality

66.8

Promoting interoperability

100

Improvement activities

40

Cost

75.45

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: john.conrad@hca6.eclinicaldirectplus.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.

• Lewis Gale Physicians LLC

  • Internal Medicine Physician
  • Salem, VA
  • NPI 1902977705
  Medicare reassignment Care Compare group
• Lake Spring Emergency Group, LLC

  • Emergency Medicine Physician
  • Salem, VA
  • NPI 1215429600
  Medicare reassignment

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

• Lewis-Gale Medical Center, LLC

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1043582422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4064 POSTAL DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186438",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4064 POSTAL DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186438",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JOHN",
        "middle_name": "CHRISTIAN",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110003758",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003758",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PLAN",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTOTAL",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "540506332115",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDIGAP",
            "identifier": "1043582422",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01072820",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB",
            "identifier": "1043582422",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JOHN.CONRAD@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4064 Postal Dr",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240186438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin L Connor, CRNA
• Katie Bridgette Conoboy, LCSW
• Amber Ranee Conrad, PA-C
• Ashlyn Brooke Conrad
• John C. Conrad, M.D.
• Andrea Rose Conti, D.O.
• Jessica Ellen Conway, MA, MFT
• Benjamin Ray Coobs, MD
• Bethany Cook, L.C.S.W.
• Callie Mikala Cook

• Surgical Physician Assistant in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.