Individual provider Active NPI

Dale Wilton Pcsolyar, M.D.

  • Neurology Physician
  • Fredericksburg, VA
National Provider Identifier
1104855485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101040844 Issued in VA
Practice address
220 Executive Center Pkwy
Fredericksburg, VA 22401-3107
Phone
(540) 899-2900
Fax
(540) 899-3395
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101040844 VA Primary

Addresses

Primary practice location

220 Executive Center Pkwy
Fredericksburg, VA 22401-3107

Mailing address

220 Executive Center Pkwy
Fredericksburg, VA 22401-3107
Phone (540) 899-2900

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
I20100423000350 VA Practitioner - Neurology 4789784117 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101040844VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Consulants of Tidewater PLLC CurrentSince Aug 20, 2024 Accepting new patients
Global Neuro-Diagnostics, LP CurrentSince May 11, 2011 Accepting new patients
Neurology Consultants of Tidewater, PLLC Neurology CurrentSince Aug 20, 2024 Accepting new patients

Locations

6161 Kempsville Cir
Ste 315
Norfolk, VA 23502
Phone (757) 461-5400

Organizations & group practices 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104855485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 EXECUTIVE CENTER PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013107",
            "telephone_number": "540-899-2900",
            "fax_number": "540-899-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 EXECUTIVE CENTER PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013107",
            "telephone_number": "540-899-2900",
            "fax_number": "540-899-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PCSOLYAR",
        "first_name": "DALE",
        "middle_name": "WILTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101040844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.