Individual provider Active NPI

Antonio J. Eppolito, MD

  • Family Medicine Physician
  • Kirtland AFB, NM
National Provider Identifier
1306823067
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-061878-L Issued in PA
Practice address
2050 2ND St SE
Kirtland AFB, NM 87117-5522
Phone
(505) 853-0140
NPI assigned
Dec 23, 2005
Last updated
Jun 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-061878-L PA Primary

Addresses

Primary practice location

2050 2ND St SE
Kirtland AFB, NM 87117-5522

Mailing address

2050 2ND St SE
Kirtland AFB, NM 87117-5522
Phone (505) 853-0140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419000039 DC Practitioner - Family Practice 9931337185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Rochester School of Medicine and Dentistry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1701 N George Mason Dr
Arlington, VA 22205-3698

2800 S Shirlington Rd
Suite 600
Arlington, VA 22206-3608
Phone (703) 717-4245

764 23Rd St S
VHC Physician Group Primary Care
Arlington, VA 22202-2420
Phone (703) 717-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.33 of 100Reported as group
Quality
74.39
Promoting interoperability
87
Improvement activities
40
Cost
70.89

Merit-based Incentive Payment System (MIPS)

Final score
85.92 of 100Reported as group
Quality
87.54
Promoting interoperability
86
Improvement activities
40
Cost
77.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-061878-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Hospital Center Physician Group, LLC Current Accepting new patients
Virginia Hospital Center Physician Group LLC CurrentSince May 2, 2022 Accepting new patients
Virginia Hospital Center Physician Group, LLC CurrentSince May 2, 2022 Accepting new patients
Virginia Hospital Center Physician Group, LLC Family Medicine Past Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

764 23rd St S
Arlington, VA 22202
Phone (703) 717-7000

Interoperability endpoints

  • Direct secure messaging: aeppolito93336@direct.virginiahospitalcenter.net

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, 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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1306823067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-853-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-853-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPOLITO",
        "first_name": "ANTONIO",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-061878-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirtland AFB, NM

Sources for this page

Verify at the official NPI Registry.