Jackson F Agraz, MD
Individual provider Active NPI Emergency Medicine Physician · Charlottesville, VA
NPI 1306423397 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1306423397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0101282070 (VA)
- Practice address
- 1215 Lee St
Charlottesville, VA 22908-0816 - Phone
- (434) 924-2231
- Fax
- (434) 924-9295
- NPI assigned
- Mar 25, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Virginia Physicians Group
Practice addresses (Care Compare)
1215 Lee St
Charlottesville, VA 22908-2325
Phone (434) 924-8129
Hospital & facility affiliations
- University of Virginia Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240522002634 | VA | Practitioner - Emergency Medicine | 6901248921 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Virginia Physicians Group | Current |
Accepting new patients | |
| Shenandoah Emergency Medicine Specialists LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Services of VA, LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500
1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211
78 Medical Center Dr
Fishersville, VA 22939
Phone (540) 245-7216
5005 Plank Rd
Fredericksburg, VA 22407
Phone (540) 736-6900
4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000
Interoperability endpoints
- jagraz486125@direct.healthsystem.virginia.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0101282070 | VA | Yes |
Addresses
Primary practice location
1215 Lee St
Charlottesville, VA 22908-0816
Mailing address
PO Box 749112
Atlanta, GA 30374-9112
Other providers in Charlottesville, VA
- Elisha Agee
- Ankur Aggarwal
- Irene Olabisi Aghahowa
- Benjamin Agnor
- Arshi Agrawal
- Lindsay Alice Aguero
- Alexia Aguilar
- Lauren Nicole Aguilar
- Manuela C. Aguilar
- Nadine S. Aguilera
All providers in Charlottesville, VA · Emergency Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.