Individual provider Active NPI

Stephanie Padilla

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1043880610
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-008153 Issued in VA
Practice address
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone
(434) 200-3000
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-008153 VA Primary

Addresses

Primary practice location

1901 Tate Springs Rd
Lynchburg, VA 24501-1109

Mailing address

133 Richeson Dr
Lynchburg, VA 24501-2911

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
I20211110001102 VA Practitioner - Physician Assistant 6103215355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-008153VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Oct 15, 2021 Accepting new patients
Centra Medical Group, LLC CurrentSince Oct 15, 2021 Accepting new patients

Locations

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

Organizations & group practices 2

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 7

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1043880610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 RICHESON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011109",
            "telephone_number": "434-200-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-008153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.