Individual provider Active NPI

Victoria Lee Vastine, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1174587141
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
0101057657 Issued in VA
Practice address
595 Martha Jefferson Dr Ste 280
Charlottesville, VA 22911-4669
Phone
(434) 654-8920
Fax
(434) 654-8921
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 0101057657 VA Primary

Addresses

Primary practice location

595 Martha Jefferson Dr Ste 280
Charlottesville, VA 22911-4669

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Other names 1

  • Victoria Lee Vastine-Folger Other name

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
I20050517000183 VA Practitioner - Plastic and Reconstructive Surgery 6305887746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Virginia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

595 Martha Jefferson Dr
Suite 280
Charlottesville, VA 22911-4669
Phone (434) 654-8920

Hospital & facility affiliations

  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy26
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC CurrentSince Apr 1, 2012 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Commonwealth Orthopedic Specialist Past Accepting new patients
Martha Jefferson Hospital Past Accepting new patients

Locations

595 Martha Jefferson Dr
Ste 280
Charlottesville, VA 22911
Phone (434) 654-8920

595 Martha Jefferson Dr
#280
Charlottesville, VA 22911

600 Peter Jefferson Pkwy
Ste 270
Charlottesvle, VA 22911
Phone (434) 654-8920

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

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.

Hospital & facility affiliations 1

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1174587141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 MARTHA JEFFERSON DR STE 280",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114669",
            "telephone_number": "434-654-8920",
            "fax_number": "434-654-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTINE",
        "first_name": "VICTORIA",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "VA",
            "license": "0101057657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "VASTINE-FOLGER",
            "middle_name": "LEE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.