Michelle Pauciullo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110010064 Issued in VA

Practice address

3864 Old Buckingham Rd Ste B
Powhatan, VA 23139-7019

Phone

(804) 794-2821

NPI assigned

May 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpauciullo37455@direct.orthovirginia.com

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.

• Orthovirginia Inc

  • Multi-Specialty Clinic/Center
  • Mechanicsville, VA
  • NPI 1487671822
  Medicare reassignment Care Compare group
• Orthovirginia, Inc

  • Physical Medicine & Rehabilitation Physician
  • Arlington, VA
  • NPI 1376411413
  NPD
• Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • Forest, VA
  • NPI 1649748526

  Physician Assistant

  NPD
• Pediatric & Adolescent Health Partners, P.C.

  • Pediatrics Physician
  • Midlothian, VA
  • NPI 1851458178
  NPD (past)

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1083463434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 CARIBBEAN LN",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238328425",
            "telephone_number": "703-638-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3864 OLD BUCKINGHAM RD STE B",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397019",
            "telephone_number": "804-794-2821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13821 Village Mill Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231144314",
            "country_code": "US",
            "telephone_number": "804-794-2821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUCIULLO",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicholas
• Richard Nickerson, M.D.
• Jennifer O'Neill, NBCHWC
• Sigitas Pachanavicius
• Patriot Medical Care PLLC
• Patrick Peach, ATC
• Pediatric Partners of Virginia
• Richard Pelletier, RPH
• Peter Matkowsky DDS Inc.
• Simon Gerard Petrizzi, DDS

• Physician Assistant in Powhatan, VA
• Providers in Powhatan, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.