Individual provider Active NPI

Shadi Ghadermarzi, MD

  • Hospitalist Physician
  • Tappahannock, VA
National Provider Identifier
1073040226
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0101271541 Issued in VA
Practice address
618 Hospital Rd
Tappahannock, VA 22560-5000
Phone
(804) 443-3311
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2020-04504 NC
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 0101271541 VA Primary

Addresses

Primary practice location

618 Hospital Rd
Tappahannock, VA 22560-5000

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4268

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210512001539 VA Practitioner - HospitalistPractitioner - Internal Medicine 0143594168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1300 E Marshall St
Richmond, VA 23298-5028
Phone (804) 828-0450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2020-04504NCMDHospitalist Physician
0101271541VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. Hospitalist CurrentSince Apr 1, 2021 Accepting new patients
Riverside Physician Services Inc CurrentSince Apr 1, 2021 Accepting new patients
MCV Associated Physicians CurrentSince Apr 1, 2021 Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1300 E Marshall St
Richmond, VA 23298
Phone (804) 828-3144

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

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 3

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073040226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 HOSPITAL RD",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225605000",
            "telephone_number": "804-443-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-847-4268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHADERMARZI",
        "first_name": "SHADI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2020-04504",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101271541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tappahannock, VA

Sources for this page

Verify at the official NPI Registry.