Individual provider Active NPI

Jay C. Fertile, MD

  • Diagnostic Radiology Physician
  • Charlottesville, VA
National Provider Identifier
1104899616
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101057922 Issued in VA
Practice address
500 Martha Jefferson Dr
Charlottesville Radiology
Charlottesville, VA 22911-4668
Phone
(434) 244-4580
Fax
(434) 244-4579
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101057922 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville Radiology
Charlottesville, VA 22911-4668

Mailing address

PO Box 197
State College, PA 16804-0197

Other identifiers 2

IdentifierTypeStateIssuer
007233761MedicaidVA
300123077OtherVARRMED

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfertile246055@direct.sentara.net Direct

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
I20100513000204 VA Practitioner - Diagnostic Radiology 9638253636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Virginia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlottesville Radiology LTDGroup PAC ID 1557259959, 10 clinicians

Practice addresses (Care Compare)

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-7106

Hospital & facility affiliations

  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077

Merit-based Incentive Payment System (MIPS)

Final score
93.35 of 100Reported as group
Quality
83.39
Improvement activities
40
Cost
100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charlottesville Radiology LTD Diagnostic Radiology CurrentSince Aug 1, 2001 Accepting new patients
Sentara Advanced Imaging Solutions, LLC Diagnostic Radiology CurrentSince Nov 14, 2022 Accepting new patients
Allegheny Clinic Radiology Diagnostic Radiology Past Accepting new patients
Radiology Physicians Inc Diagnostic Radiology Past Accepting new patients

Locations

435 Merchant Walk Sq
Ste 400
Charlottesville, VA 22902
Phone (434) 654-1800

595 Martha Jefferson Dr
Charlottesville, VA 22911
Phone (434) 293-4995

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

920 E High St
Ste 1
Charlottesvle, VA 22902
Phone (434) 654-1980

3263 Proffit Rd
Charlottesvle, VA 22911
Phone (434) 654-4650

29 Jefferson Ct
Zion Crossroads, VA 22942
Phone (434) 654-8900

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1104899616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168040197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "address_2": "CHARLOTTESVILLE RADIOLOGY",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-244-4580",
            "fax_number": "434-244-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTILE",
        "first_name": "JAY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101057922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007233761",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMED",
            "identifier": "300123077",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfertile246055@direct.sentara.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 Martha Jefferson Dr",
            "address_2": "Charlottesville Radiology",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229114668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.