Individual provider Active NPI

Fotini Vavelidis, MS,CGC

  • Genetic Counselor (M.S.)
  • San Carlos, CA
National Provider Identifier
1184749160
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
0139000044 Issued in VA
Practice address
201 Industrial Rd Ste 410
San Carlos, CA 94070-2396
Phone
(650) 249-9090
Fax
(650) 412-2305
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 0139000044 VA Primary
Genetic Counselor (M.S.) 170300000X

Addresses

Primary practice location

201 Industrial Rd Ste 410
San Carlos, CA 94070-2396

Mailing address

201 Industrial Rd Ste 410
San Carlos, CA 94070-2396
Phone (650) 249-9090

Other practice location 1

600 Peter Jefferson Pkwy
Suite 190
Charlottesville, VA 22911-8835
Phone (434) 220-8623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0139000044VAMDGenetic Counselor (M.S.)

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Skin, LLC PastSince Sep 1, 2023 Accepting new patients
Siva Thiagarajah, MD PastSince Aug 1, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00421

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1184749160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 INDUSTRIAL RD STE 410",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702396",
            "telephone_number": "650-249-9090",
            "fax_number": "650-412-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 INDUSTRIAL RD STE 410",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702396",
            "telephone_number": "650-249-9090",
            "fax_number": "650-412-2305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Peter Jefferson Pkwy",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229118835",
            "country_code": "US",
            "telephone_number": "434-220-8623",
            "fax_number": "434-220-8625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAVELIDIS",
        "first_name": "FOTINI",
        "credential": "MS,CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "VA",
            "license": "0139000044",
            "primary": true
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.