NPIMap

Individual provider Active NPI

Itzhak Avital, M.D.

  • Surgery Physician
  • Richmond, VA
National Provider Identifier
1245512565
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101251459 Issued in VA
Practice address
5875 Bremo Rd
Suite 209
Richmond, VA 23226-1934
Phone
(804) 893-8681
Fax
(804) 287-8525
NPI assigned
Sep 13, 2011
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101251459 VA Primary
Surgical Oncology Physician 2086X0206X 231941 NY

Addresses

Primary practice location

5875 Bremo Rd
Suite 209
Richmond, VA 23226-1934

Mailing address

5875 Bremo Rd
Suite 209
Richmond, VA 23226-1934
Phone (804) 893-8681

Other identifiers 2

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN
C06695OtherVAGROUP PTAN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231941NYMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Surgical Oncology Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Bon Secours-Virginia Healthsource Inc Surgery Past Accepting new patients
Harness Health Pharmacy - Central Pharmacy Services LLC Past Accepting new patients

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, 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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1245512565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITE 209",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-893-8681",
            "fax_number": "804-287-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITE 209",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-893-8681",
            "fax_number": "804-287-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVITAL",
        "first_name": "ITZHAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101251459",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "231941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.