NPIMap

Individual provider Active NPI

Hershel Mack, PA-C, ATC

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1245887835
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
885 Schumann Dr
Virginia Beach, VA 23454-6878
Phone
(757) 708-1621
NPI assigned
Aug 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126001007 VA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

885 Schumann Dr
Virginia Beach, VA 23454-6878

Mailing address

4111 Monarch Way Ste 500
Norfolk, VA 23508-2563
Phone (757) 477-6812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915001257 VA Practitioner - Physician Assistant 1850755471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

1115 Boulders Pkwy
North Chesterfield, VA 23225-4067

1717 Will O Wisp Dr
Suite 100
Virginia Beach, VA 23454-3102
Phone (757) 422-8476

667 Kingsborough SQ
Suite 300
Chesapeake, VA 23320-4999
Phone (757) 422-5476

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as group
Quality
90.74
Promoting interoperability
100
Improvement activities
40
Cost
78.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0126001007VAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc. Physician Assistant CurrentSince Jul 10, 2023 Accepting new patients
Orthovirginia, Inc CurrentSince Jul 10, 2023 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation PastSince Jun 11, 2023 Accepting new patients
Orthovirginia, Inc. Past Accepting new patients

Locations

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

1717 Will O Wisp Dr
Ste 100
Virginia Beach, VA 23454
Phone (757) 422-8476

Interoperability endpoints

  • Direct secure messaging: hmack36132@direct.orthovirginia.com

Organizations & group practices 5

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 11

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1245887835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 MONARCH WAY STE 500",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235082563",
            "telephone_number": "757-477-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 SCHUMANN DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234546878",
            "telephone_number": "757-708-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "HERSHEL",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001007",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.