Individual provider Active NPI

Mikayla Lynn Price Mukashev, PA-C

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1134848302
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008712 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110008712 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

5801 Bremo Rd
Richmond, VA 23226-1907

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101000350 VA Practitioner - Physician Assistant 3577930767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 686-3508

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110008712VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Nov 15, 2022 Accepting new patients
Cep America, LLC CurrentSince Nov 15, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1134848302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKASHEV",
        "first_name": "MIKAYLA",
        "middle_name": "LYNN PRICE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.