NPIMap

Individual provider Active NPI

Salvatore Karl Bavuso, M.D.

  • Family Medicine Physician
  • Lively, VA
National Provider Identifier
1407835937
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101239782 Issued in VA
Practice address
36 Lively Oaks Rd
Lively, VA 22507
Phone
(804) 462-5155
Fax
(804) 462-5922
NPI assigned
Jan 12, 2006
Last updated
Aug 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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 0101239782 VA Primary

Addresses

Primary practice location

36 Lively Oaks Rd
Lively, VA 22507

Mailing address

PO Box 1328
Kilmarnock, VA 22482-1328
Phone (804) 435-8570

Other identifiers 2

IdentifierTypeStateIssuer
410368OtherVAANTHEM BC/BS
1407835937MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060626000270 VA Practitioner - Family Practice 6406868942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rappahannock Westminster-Canterbury, Inc.Group PAC ID 6103090345, shared by 3 NPIs, 13 clinicians
Chesapeake Hospital LLCGroup PAC ID 8921060427, 14 clinicians

Practice addresses (Care Compare)

132 Lancaster Dr
Irvington, VA 22480-9740
Phone (804) 438-4000

36 Lively Oaks Rd
Lively, VA 22507
Phone (804) 462-5155

402 N Main St
Kilmarnock, VA 22482-3825
Phone (804) 435-2651

8152 Northumberland Hwy
Heathsville, VA 22473-3309
Phone (804) 580-7200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239782VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Hospital LLC CurrentSince Dec 22, 2021 Accepting new patients
Chesapeake Hospital Corporation Past Accepting new patients
Tidewater Physicians Multispecialty Group PC Past Accepting new patients
Chesapeake Medical Group Family Medicine Past Accepting new patients

Locations

9891 General Puller Hwy
Hartfield, VA 23071
Phone (804) 435-0991

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD
  • Direct secure messaging: sbavuso1149368@direct.bsmhealth.org

Organizations & group practices 5

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 10

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1407835937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224821328",
            "telephone_number": "804-435-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 LIVELY OAKS RD",
            "city": "LIVELY",
            "state": "VA",
            "postal_code": "22507",
            "telephone_number": "804-462-5155",
            "fax_number": "804-462-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVUSO",
        "first_name": "SALVATORE",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101239782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "410368",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407835937",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lively, VA

Sources for this page

Verify at the official NPI Registry.