Individual provider Active NPI

Eva Marie McEwen, PA

  • Physician Assistant
  • Hampton, VA
National Provider Identifier
1194357863
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-007292 Issued in VA
Practice address
901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone
(757) 827-2480
Fax
(757) 299-9917
NPI assigned
Feb 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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 0110-007292 VA Primary

Addresses

Primary practice location

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250

Mailing address

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Other names 1

  • Eva Marie Ellis Former 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630002326 VA Practitioner - Physician Assistant 7810310315 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid Atlantic Long Term Specialty Care LLCGroup PAC ID 8921427162, 28 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

National Provider Directory

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

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1194357863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PKWY STE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666250",
            "telephone_number": "757-827-2480",
            "fax_number": "757-299-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PKWY STE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666250",
            "telephone_number": "757-827-2480",
            "fax_number": "757-299-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "EVA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-007292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVA",
            "last_name": "ELLIS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.