Individual provider Active NPI

Brian Wayne McCauley, PA-C

  • Physician Assistant
  • Petersburg, VA
National Provider Identifier
1073777306
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002810 Issued in VA
Practice address
200 Medical Park Blvd
Petersburg, VA 23805-5149
Phone
(804) 765-5000
NPI assigned
Jul 16, 2008
Last updated
Apr 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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 0110002810 VA Primary

Addresses

Primary practice location

200 Medical Park Blvd
Petersburg, VA 23805-5149

Mailing address

9058 Old Springfield Rd
Glen Allen, VA 23060-6327
Phone (804) 306-0550

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
I20080919000486 VA Practitioner - Physician Assistant 4486556164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James River Dermatology PLLCGroup PAC ID 1759430457, 9 clinicians

Practice addresses (Care Compare)

1316 Alverser PLZ
Midlothian, VA 23113-2604
Phone (804) 379-0116

6372 Mechanicsville Tpke
Suite 103
Mechanicsville, VA 23111-4710
Phone (804) 379-0116

Merit-based Incentive Payment System (MIPS)

Final score
91.81 of 100Reported as group
Quality
94.68
Improvement activities
40
Cost
79.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002810VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James River Dermatology PLLC CurrentSince Nov 30, 2022 Accepting new patients
Virginia Em-I Medical Services, PC Past Accepting new patients

Locations

6372 Mechanicsville Tpke
Ste 103
Mechanicsville, VA 23111
Phone (804) 379-0116

1316 Alverser Plz
Midlothian, VA 23113
Phone (804) 291-8636

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCHAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1073777306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9058 OLD SPRINGFIELD RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606327",
            "telephone_number": "804-306-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238055149",
            "telephone_number": "804-765-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "BRIAN",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.