NPIMap

Individual provider Active NPI

James V Pellicane Jr., MD, FACS

  • Surgery Physician
  • Midlothian, VA
National Provider Identifier
1093704454
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101045452 Issued in VA
Practice address
14051 St Francis Blvd
Suite 2210
Midlothian, VA 23114-3201
Phone
(804) 594-3130
Fax
(804) 594-3030
NPI assigned
Oct 18, 2005
Last updated
Nov 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101045452 VA Primary

Addresses

Primary practice location

14051 St Francis Blvd
Suite 2210
Midlothian, VA 23114-3201

Mailing address

14051 St Francis Blvd
Suite 2210
Midlothian, VA 23114-3201
Phone (804) 594-3130

Other identifiers 1

IdentifierTypeStateIssuer
C09633OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050921000478 VA Practitioner - General SurgeryPractitioner - Other (Physician) 0042244816 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Pittsburgh School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

5875 Bremo Rd
Richmond, VA 23226-1928

8266 Atlee Rd
Suite 219
Mechanicsville, VA 23116-1806
Phone (804) 594-3130

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy102
Melanoma (skin cancer) excision13
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Medical Center LLC CurrentSince Apr 1, 2020 Accepting new patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Apr 1, 2020 Accepting new patients
Bon Secours St. Francis Medical Center LLC Current Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC Surgery CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC CurrentSince Apr 1, 2020 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients
Richmond Surgical Group Inc Surgery Past Accepting new patients

Locations

8220 Meadowbridge Rd
Ste 309
Mechanicsville, VA 23116
Phone (804) 594-3130

8266 Atlee Rd
Ste 219
Mechanicsville, VA 23116
Phone (804) 594-3130

13700 St Francis Blvd
Ste 510
Midlothian, VA 23114
Phone (804) 423-8462

14051 St Francis Blvd
Ste 2210
Midlothian, VA 23114
Phone (804) 594-3130

601 Watkins Centre Pkwy
Ste 200
Midlothian, VA 23114
Phone (804) 594-3130

611 Watkins Centre Pkwy
Ste 250
Midlothian, VA 23114
Phone (804) 423-8470

210 Medical Park Blvd
Ste 275
Petersburg, VA 23805
Phone (804) 765-5886

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

5875 Bremo Rd
Ste 701
Richmond, VA 23226
Phone (804) 282-8350

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Organizations & group practices 11

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1093704454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 ST FRANCIS BLVD",
            "address_2": "SUITE 2210",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143201",
            "telephone_number": "804-594-3130",
            "fax_number": "804-594-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14051 ST FRANCIS BLVD",
            "address_2": "SUITE 2210",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143201",
            "telephone_number": "804-594-3130",
            "fax_number": "804-594-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICANE",
        "first_name": "JAMES",
        "middle_name": "V",
        "name_suffix": "Jr.",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101045452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.