NPIMap

Individual provider Active NPI

Richard E Vasicek, DO

  • Family Medicine Physician
  • Fairmont, WV
National Provider Identifier
1316037146
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1552 Issued in WV
Practice address
177 Middletown Rd Ste 1
Fairmont, WV 26554-8254
Phone
(304) 363-6600
NPI assigned
Oct 13, 2006
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 1552 WV Primary

Addresses

Primary practice location

177 Middletown Rd Ste 1
Fairmont, WV 26554-8254

Mailing address

PO Box 763
Morgantown, WV 26507-0763
Phone (800) 541-4009

Other identifiers 3

IdentifierTypeStateIssuer
0047267000MedicaidWV
000558950OtherBC
0010879001OtherWVMCAID WM LAB

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rvasicek49106@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address rvasicek49106@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040130000251 WV Practitioner - Family Practice 3274436084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
United Physicians Care Inc Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Bridgeport Health Care Center, LLC Past Accepting new patients
BP WV Maplewood Leasing Co., LLC Past Accepting new patients
Whitehall Medical PLLC Family Medicine Past Accepting new patients

Locations

1370 Johnson Ave
Ste 102
Bridgeport, WV 26330
Phone (681) 342-3452

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

710 Genesis Blvd
#C30572
Bridgeport, WV 26330
Phone (681) 342-3490

626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

177 Middletown Rd
Ste 1
White Hall, WV 26554
Phone (304) 363-6600

Interoperability endpoints

  • Direct secure messaging: rvasicek49106@direct.wvuhsdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maplewood Healthcare CenterBridgeport, WV, CCN 515194 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 14, 2023
Apr 14, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 6

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1316037146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 763",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070763",
            "telephone_number": "800-541-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD STE 1",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548254",
            "telephone_number": "304-363-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASICEK",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0047267000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "000558950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAID WM LAB",
            "identifier": "0010879001",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rvasicek49106@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "177 Middletown Rd Ste 1",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265548254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rvasicek49106@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "177 Middletown Rd",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265548254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.