Tedric D Lolis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008916 Issued in VA

Practice address

1215 Lee St
Charlottesville, VA 22908-0816

Phone

(434) 924-9400

NPI assigned

Apr 18, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV, VA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Mountain Health Physicians IncGroup PAC ID 9133405327, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008
• Winchester Medical Center Hospital, Winchester, VA, CCN 490005
• Jefferson Medical Center Hospital, Ranson, WV, CCN 511319

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tlolis936354@soc.inova.org
• Direct secure messaging: tlolis936354@valleyhealth.direct-ci.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.

• East Mountain Health Physicians Inc.

  • Family Medicine Physician
  • Martinsburg, WV
  • NPI 1114460797
  Medicare reassignment Care Compare group NPD (past)
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment
• East Mountain Health Physicians, Inc.

  • Family Medicine Physician
  • Martinsburg, WV
  • NPI 1225678246
  NPD
• East Mountain Health Physicians, Inc.

  • Orthopaedic Surgery Physician
  • Martinsburg, WV
  • NPI 1437885365
  NPD
• East Mountain Health Physicians, Inc.

  • Occupational Medicine Clinic/Center
  • Ranson, WV
  • NPI 1841711512
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Winchester Medical Center

  • General Acute Care Hospital
  • Winchester, VA
  • NPI 1619928017
  Care Compare affiliation
• Winchester Medical Center

  • Clinical Medical Laboratory
  • Winchester, VA
  • NPI 1790024909

  Hospital

  Care Compare affiliation
• City Hospital, Inc

  • General Acute Care Hospital
  • Martinsburg, WV
  • NPI 1457389249
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ranson, WV
  • NPI 1104242569
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1316364953

  Hospital

  Care Compare affiliation
• Jefferson Memorial Hospital

  • Critical Access Hospital
  • Ranson, WV
  • NPI 1891722377
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Anesthesiology Physician
  • Ranson, WV
  • NPI 1982704961

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1114660289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Tavern Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254012801",
            "country_code": "US",
            "telephone_number": "304-263-5129",
            "fax_number": "304-263-3726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOLIS",
        "first_name": "TEDRIC",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlolis936354@soc.inova.org",
            "affiliation": "N",
            "address_1": "1008 Tavern Rd Ste 102",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hailey Loeser, BT
• Adrian Ignacio Loffler, M.D.
• David Loftus
• Katherine D Lohr, PHD, LCP
• Sara Loker
• Ivonne Valentina Lollett, MD
• William Charles Lombardi, AG-ACNP
• Nicholas Lombardo, PHARMD
• Francesca Lomonaco, LCSW
• Kevin Patrick Lonabaugh, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.