Individual provider Active NPI

Keonna Chwiliniski, MPA, PA-C

  • Physician Assistant
  • Suffolk, VA
National Provider Identifier
1285443564
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011162 Issued in VA
Practice address
3060 Godwin Blvd
Suffolk, VA 23434-8274
Phone
(757) 923-9660
Fax
(757) 923-9665
NPI assigned
Jan 2, 2025
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110011162 VA Primary

Addresses

Primary practice location

3060 Godwin Blvd
Suffolk, VA 23434-8274

Mailing address

3060 Godwin Blvd
Suffolk, VA 23434-8274
Phone (757) 923-9660

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
I20250909000051 VA Practitioner - Physician Assistant 8921500927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 934-9395

3060 Godwin Blvd
Suffolk, VA 23434-8274
Phone (757) 923-9660

4868 Bridge Rd
Suffolk, VA 23435-2048
Phone (757) 483-7113

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110011162VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

3060 Godwin Blvd
Suffolk, VA 23434
Phone (757) 923-9660

Organizations & group practices 2

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.

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": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1285443564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348274",
            "telephone_number": "757-923-9660",
            "fax_number": "757-923-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348274",
            "telephone_number": "757-923-9660",
            "fax_number": "757-923-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHWILINISKI",
        "first_name": "KEONNA",
        "credential": "MPA, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.