Individual provider Active NPI

Philip Tyler Gastrell

  • Neurology Physician
  • Richmond, VA
National Provider Identifier
1134574841
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101272771 Issued in VA
Practice address
417 N 11TH St
Richmond, VA 23298-5024
Phone
(804) 828-9350
Fax
(804) 807-7949
NPI assigned
May 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 0101272771 VA Primary

Addresses

Primary practice location

417 N 11TH St
Richmond, VA 23298-5024

Mailing address

2691 Southern Hills CT
North Garden, VA 22959-1640
Phone (703) 405-4178

Other practice location 1

2691 Southern Hills Ct
North Garden, VA 22959-1640
Phone (703) 405-4178

Other practice location 2

11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 828-9350

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
I20240228004864 VA Practitioner - Neurology 4587906664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Duke University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 364-6641

Hospital & facility affiliations

  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
  • Community Memorial Hospital Hospital, South Hill, VA, CCN 490098

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Neurology CurrentSince Dec 10, 2023 Accepting new patients

Locations

11958 W Broad St
Richmond, VA 23233
Phone (804) 360-4669

417 N 11th St
Richmond, VA 23298
Phone (804) 828-0733

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Organizations & group practices 1

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 3

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": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1134574841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 SOUTHERN HILLS CT",
            "city": "NORTH GARDEN",
            "state": "VA",
            "postal_code": "229591640",
            "telephone_number": "703-405-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985024",
            "telephone_number": "804-828-9350",
            "fax_number": "804-807-7949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2691 Southern Hills Ct",
            "address_purpose": "LOCATION",
            "city": "North Garden",
            "state": "VA",
            "postal_code": "229591640",
            "country_code": "US",
            "telephone_number": "703-405-4178",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11958 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "232331007",
            "country_code": "US",
            "telephone_number": "804-828-9350",
            "fax_number": "804-364-6521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASTRELL",
        "first_name": "PHILIP",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101272771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.