Individual provider Active NPI

Andrea Nicole Hebert, PA-C

  • Surgical Physician Assistant
  • Roanoke, VA
National Provider Identifier
1063601607
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110002647 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 725-1226
Fax
(540) 857-5306
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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 0110002647 VA
Surgical Physician Assistant 363AS0400X 0110002647 VA Primary

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone (540) 725-1226

Other identifiers 12

IdentifierTypeStateIssuer
1063601607OtherVAANTHEM MEDIGAP
1063601607OtherVAUMWA
P00834686OtherVARAILROAD MEDICARE
1063601607OtherVAOPTIMA HEALTH PLAN
1063601607OtherVAHUMANA MEDICARE
1063601607OtherVAAETNA
1063601607OtherVACCC VIRGINIA PREMIER
1063601607OtherVASOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
1063601607OtherVAINTOTAL
1063601607OtherVAMEDICAID QMB
1063601607OtherVABLACK LUNG
540506332115OtherVATRICARE/CHAMPUS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahebert1048@direct.carilionclinic.org Direct

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
I20080102000263 VA Practitioner - Physician Assistant 0143300251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone (540) 224-5170

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002647VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Apr 23, 2018 Accepting new patients
Carilion Medical Center CurrentSince Feb 8, 2010 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 23, 2018 Accepting new patients
Carilion Medical Center CurrentSince Feb 8, 2010 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

4064 Postal Dr
Roanoke, VA 24018
Phone (540) 776-0200

2331 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 725-1226

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Organizations & group practices 4

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 1

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1063601607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "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": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-725-1226",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002647",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDIGAP",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00834686",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PLAN",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCC VIRGINIA PREMIER",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTOTAL",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "1063601607",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "540506332115",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahebert1048@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ahebert1048@direct.carilionclinic.org",
            "address_1": "2331 Franklin Rd SW",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.