Individual provider Active NPI

Albert Manuel Molina, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1083853311
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002915 Issued in VA
Practice address
1001 Poindexter St
Chesapeake, VA 23324-2444
Phone
(757) 494-1688
Fax
(757) 494-1973
NPI assigned
Feb 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 0110002915 VA Primary

Addresses

Primary practice location

1001 Poindexter St
Chesapeake, VA 23324-2444

Mailing address

1001 Poindexter St
Chesapeake, VA 23324-2444
Phone (757) 494-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20101004000638 NC Practitioner - Physician Assistant 1557415023 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
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

210 Smith Church Rd
BLDG 1
Roanoke Rapids, NC 27870-4942
Phone (252) 535-8463

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110002915VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Halifax Regional Medical Center Inc CurrentSince Apr 9, 2017 Accepting new patients
Taylor Made Diagnostics Inc. Past Accepting new patients
Sterling Emergency Services of Virginia Inc Past Accepting new patients
Franklin Regional Emergency Physicians PLLC Past Accepting new patients
Ecs of Virginia, Inc. Past Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

210 Smith Church Rd
Ste A
Roanoke Rapids, NC 27870
Phone (252) 535-8463

210 Smith Church Rd
Ste B
Roanoke Rapids, NC 27870
Phone (252) 535-8870

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1083853311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POINDEXTER ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242444",
            "telephone_number": "757-494-1688",
            "fax_number": "757-494-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POINDEXTER ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242444",
            "telephone_number": "757-494-1688",
            "fax_number": "757-494-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "ALBERT",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.