Individual provider Active NPI

Nikta Safavi, PA-C

  • Medical Physician Assistant
  • Richmond, VA
National Provider Identifier
1265799779
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004335 Issued in VA
Practice address
1800 Glenside Dr Ste 110
Richmond, VA 23226-3769
Phone
(804) 288-1800
Fax
(804) 288-0515
NPI assigned
Apr 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-03418 NC
Medical Physician Assistant 363AM0700X 0110004335 VA Primary

Addresses

Primary practice location

1800 Glenside Dr Ste 110
Richmond, VA 23226-3769

Mailing address

1800 Glenside Dr
Ste 105
Richmond, VA 23226-3769
Phone (804) 288-2762

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
I20140930002423 VA Practitioner - Physician Assistant 8820246986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Primary CareGroup PAC ID 2264420918, 65 clinicians

Practice addresses (Care Compare)

1800 Glenside Dr
Richmond, VA 23226-3769

7140 Hull St Rd
Suite 101
Richmond, VA 23235-5802
Phone (804) 276-4141

Hospital & facility affiliations

  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110004335VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Primary Care CurrentSince Jun 1, 2015 Accepting new patients

Locations

7140 Hull Street Rd
Ste 101
North Chesterfield, VA 23235
Phone (804) 276-4141

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

1800 Glenside Dr
Ste 110
Richmond, VA 23226
Phone (804) 288-1800

Interoperability endpoints

  • Direct secure messaging: nikta.safavi@cpcva.eclinicaldirectplus.com

Organizations & group practices 1

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1265799779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "STE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-2762",
            "fax_number": "804-285-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR STE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-1800",
            "fax_number": "804-288-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAVI",
        "first_name": "NIKTA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03418",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.