Active NPI
Andyara Euzebio Passos, PA-C
- Physician Assistant
- South Charleston, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2742
- Practice address
- 4605 Maccorkle Ave SW
South Charleston, WV 25309-1311 - Phone
- (304) 766-3600
- NPI assigned
- Jun 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2742 | WV | |
| Physician Assistant | 363A00000X | 2742 | WV | Primary |
Addresses
Primary practice location
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Mailing address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 766-3600
Other practice location 1
1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone (304) 647-4411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2742 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Princeton Community Hospital Assn Inc. | Current | Accepting new patients | |
| West Virginia Health Care Cooperative Inc | Physician Assistant | Current | Accepting new patients |
| Charleston Area Medical Center, Inc. | Current | Accepting new patients | |
| Camc Greenbrier Valley Medical Center Inc | Current | Accepting new patients | |
| West Virginia Health Care Cooperative Inc | Current | Accepting new patients | |
| Camden-Clark Physician Corporation | Current | Accepting new patients | |
| Charleston Area Medical Center Inc | Current | Accepting new patients | |
| Princeton Community Hospital Assn., Inc | Current | Accepting new patients | |
| Camc Greenbrier Valley Medical Center, Inc. | Current | Accepting new patients | |
| Princeton Community Hospital Assn. Inc. | Past | Accepting new patients |
Locations
401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325
400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762
800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161
800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405
122 12th St
Princeton, WV 24740
Phone (304) 487-7061
1521 Maplewood Ave
Ronceverte, WV 24970
1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870
400 Fairview Heights Rd
Summersville, WV 26651
Phone (304) 872-2891
Organizations & group practices 12
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.
-
- Internal Medicine Physician
- South Charleston, WV
- NPI 1871866806
-
- Cardiovascular Disease Physician
- Ronceverte, WV
- NPI 1588373872
-
- Surgery Physician
- Parkersburg, WV
- NPI 1710125430
-
dba Mercer Medical Group
- Urology Physician
- Princeton, WV
- NPI 1093917643
-
dba Summersville Regional Medical Center
- Critical Access Hospital
- Summersville, WV
- NPI 1043778319
-
dba SRMC Medical Group
- Hospitalist Physician
- Summersville, WV
- NPI 1417415324
Physician Assistant
-
- General Acute Care Hospital
- Charleston, WV
- NPI 1124248752
-
dba CAMC Greenbrier Valley Medical Center Primary Care
- Rural Health Clinic/Center
- Peterstown, WV
- NPI 1588485478
-
dba CAMC GVMC Physician Department
- Hospitalist Physician
- Ronceverte, WV
- NPI 1972125995
-
- Multi-Specialty Clinic/Center
- Belpre, OH
- NPI 1588422547
-
dba Bluefield Internal Medicine
- Rural Health Clinic/Center
- Bluefield, VA
- NPI 1235446485
-
dba PCH Behavioral Health Center
- Psychiatric Hospital Unit
- Bluefield, WV
- NPI 1619053329
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ronceverte, WV
- NPI 1679299408
-
dba Thomas Memorial Hospital
- General Acute Care Hospital
- South Charleston, WV
- NPI 1316925506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757894400000",
"number": "1194419994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4605 MACCORKLE AVE SW",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253091311",
"telephone_number": "304-766-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MACCORKLE AVE SW",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253091311",
"telephone_number": "304-766-3600"
}
],
"practiceLocations": [
{
"address_1": "1320 Maplewood Ave",
"address_purpose": "LOCATION",
"city": "Ronceverte",
"state": "WV",
"postal_code": "249708016",
"country_code": "US",
"telephone_number": "304-647-4411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PASSOS",
"first_name": "ANDYARA",
"middle_name": "EUZEBIO",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-05",
"last_updated": "2025-09-15",
"certification_date": "2025-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WV",
"license": "2742",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "2742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.