Individual provider Active NPI

Hector Marquez, M.D.

  • Anesthesiology Physician
  • South Boston, VA
National Provider Identifier
1306899406
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101050274 Issued in VA
Practice address
2204 Wilborn Ave
South Boston, VA 24592-1645
Phone
(434) 517-3139
Fax
(434) 572-6716
NPI assigned
May 18, 2006
Last updated
Aug 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101050274 VA Primary

Addresses

Primary practice location

2204 Wilborn Ave
South Boston, VA 24592-1645

Mailing address

PO Box 444
South Boston, VA 24592-0444
Phone (434) 572-3323

Other identifiers 3

IdentifierTypeStateIssuer
077059OtherVAANTHEM BCBS
5701180MedicaidVA
890515ZOtherNCMEDICAID OF NORTH CAROLIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080620000306 VA Practitioner - Anesthesiology 7911078829 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101050274VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Health Medical Associates LTD CurrentSince Jan 5, 2020 Accepting new patients
Dominion Health Medical Assoc. Current Accepting new patients
Premier Anesthesia of Virginia LLC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
Souza & Associates, Inc., P.C. Past Accepting new patients

Locations

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

504 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3400

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1306899406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 444",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245920444",
            "telephone_number": "434-572-3323",
            "fax_number": "434-572-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921645",
            "telephone_number": "434-517-3139",
            "fax_number": "434-572-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "HECTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101050274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "077059",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5701180",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF NORTH CAROLIN",
            "identifier": "890515Z",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.