Individual provider Active NPI

Richard W Dooley, P.A.

  • Medical Physician Assistant
  • Roanoke, VA
National Provider Identifier
1265628432
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002639 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-8574
Fax
(540) 983-1133
NPI assigned
Sep 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0126000825 VA
Medical Physician Assistant 363AM0700X 0110002639 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-8574

Other identifiers 1

IdentifierTypeStateIssuer
0126000825OtherVALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdooley19551@direct.carilionclinic.org

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
I20080228000618 VA Practitioner - Physician Assistant 8123102175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0126000825VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Jun 15, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 15, 2020 Accepting new patients
Carilion Medical Center CurrentSince Sep 30, 2007 Accepting new patients
Carilion Medical Center CurrentSince Sep 30, 2007 Accepting new patients

Locations

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

2001 Crystal Spring Ave SW
Ste 201
Roanoke, VA 24014
Phone (540) 853-0100

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

Interoperability endpoints

  • Direct secure messaging: rdooley19551@direct.carilionclinic.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1265628432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-8574",
            "fax_number": "540-983-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-8574",
            "fax_number": "540-983-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLEY",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0126000825",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0126000825",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdooley19551@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "rdooley19551@direct.carilionclinic.org",
            "address_1": "1906 Belleview Ave SE",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.