Individual provider Active NPI

Victoria Fortin, PA

  • Physician Assistant
  • Suffolk, VA
National Provider Identifier
1063248995
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3910 Bridge Rd Unit 101
Suffolk, VA 23435-1107
Phone
(757) 942-2566
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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 VA Primary

Addresses

Primary practice location

3910 Bridge Rd Unit 101
Suffolk, VA 23435-1107

Mailing address

3910 Bridge Rd Unit 101
Suffolk, VA 23435-1107
Phone (757) 942-2566

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
I20250108003730 VA Practitioner - Physician Assistant 5991233694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Gastroenterology Institute PCGroup PAC ID 1951604677, 9 clinicians

Practice addresses (Care Compare)

2790 Godwin Blvd
Suite 205
Suffolk, VA 23434-8154
Phone (757) 942-2566

3910 Bridge Rd
Suite 101
Suffolk, VA 23435-1107
Phone (757) 942-2566

Hospital & facility affiliations

  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Bon Secours Southampton Memorial Hospital Hospital, Franklin, VA, CCN 490092
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Gastroenterology Institute PC CurrentSince Sep 15, 2024 Accepting new patients

Locations

3910 Bridge Rd
Ste 101
Suffolk, VA 23435
Phone (757) 942-2566

Interoperability endpoints

  • Direct secure messaging: victoria.fortin.1@12739.direct.athenahealth.com

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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1063248995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 BRIDGE RD UNIT 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351107",
            "telephone_number": "757-942-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 BRIDGE RD UNIT 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351107",
            "telephone_number": "757-942-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "VICTORIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.