Individual provider Active NPI

Vera Dovirak, PA

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1174016513
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006196 Issued in VA
Practice address
101 Philip Roth St
Newport News, VA 23606-1393
Phone
(757) 599-6333
Fax
(757) 591-7261
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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 0110006196 VA Primary

Addresses

Primary practice location

101 Philip Roth St
Newport News, VA 23606-1393

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

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
I20180807000312 VA Practitioner - Physician Assistant 3476801572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Aug 13, 2018 Accepting new patients
Riverside Physician Services Inc CurrentSince Aug 13, 2018 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

101 Philip Roth St
Ste 5A
Newport News, VA 23606
Phone (757) 599-6333

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

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.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1174016513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PHILIP ROTH ST",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061393",
            "telephone_number": "757-599-6333",
            "fax_number": "757-591-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVIRAK",
        "first_name": "VERA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.