Carlos Alexander Cevallos

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101285002 Issued in VA

Practice address

1 Cooper PLZ
Camden, NJ 08103-1461

Phone

(856) 342-2352

NPI assigned

May 11, 2021

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Emergency Medicine

Education

University of Virginia School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
• Community Memorial Hospital Hospital, South Hill, VA, CCN 490098
• Vcu Health Tappahannock Hospital Hospital, Tappahannock, VA, CCN 490084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MCV Associated Physicians

  dba MCV Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457

  Emergency Medicine

  Medicare reassignment Care Compare group NPD

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

• Community Memorial Hospital

  • General Acute Care Hospital
  • South Hill, VA
  • NPI 1336103738
  Care Compare affiliation
• Vcu Health Tappahannock Hospital

  • General Acute Care Hospital
  • Tappahannock, VA
  • NPI 1760580757
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  dba Medical College of Virginia Hospitals

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  dba VCU Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1174107585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "804-482-9997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1755 N Mecklenburg Ave",
            "address_purpose": "LOCATION",
            "city": "South Hill",
            "state": "VA",
            "postal_code": "239704080",
            "country_code": "US",
            "telephone_number": "434-447-3151",
            "fax_number": "434-584-5023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605000",
            "country_code": "US",
            "telephone_number": "804-443-6297",
            "fax_number": "804-443-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985023",
            "country_code": "US",
            "telephone_number": "804-828-0996",
            "fax_number": "804-628-0384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2495 Pocahontas Trl",
            "address_purpose": "LOCATION",
            "city": "Quinton",
            "state": "VA",
            "postal_code": "231411637",
            "country_code": "US",
            "telephone_number": "804-932-5500",
            "fax_number": "804-932-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEVALLOS",
        "first_name": "CARLOS",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101285002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Family Services, Inc.
• Center for Family Services, Inc.
• Center for Family Services, Inc.
• Elizabeth Ann Cerceo, MD
• Cerevita LLC
• Ri DO Cha, MD
• Saiesha Chadee, M.D.
• Jisoo Chae, MD
• Mark Chai, M.D.
• Michele Chai, PA-C

• Emergency Medicine Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.