NPIMap

Individual provider Active NPI

Arvind Z Viradia, MD

  • Internal Medicine Physician
  • Cross Lanes, WV
National Provider Identifier
1417947904
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15105 Issued in WV
Practice address
117 Goff Mountain Rd
Cross Lanes, WV 25313-1434
Phone
(304) 776-2072
Fax
(304) 776-7678
NPI assigned
Oct 26, 2005
Last updated
Dec 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15105 WV Primary

Addresses

Primary practice location

117 Goff Mountain Rd
Cross Lanes, WV 25313-1434

Mailing address

117 Goff Mountain Rd
Cross Lanes, WV 25313-1434
Phone (304) 776-2072

Other identifiers 1

IdentifierTypeStateIssuer
0071604000MedicaidWV

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
I20060206000300 WV Practitioner - Internal Medicine 4789698192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 B Goff Mountain Rd
Cross Lanes, WV 25313-1434
Phone (304) 204-1310

117 Goff Mountain Rd
Cross Lanes, WV 25313-1434
Phone (304) 776-2072

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15105WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuface Laser & Medispa LLC CurrentSince Jul 1, 2004 Accepting new patients
Patel Inc. PastSince Jul 1, 1999 Accepting new patients

Locations

117 Goff Mountain Rd
#B
Cross Lanes, WV 25313
Phone (304) 204-1310

Interoperability endpoints

  • Direct secure messaging: aviradia@crosslanesimgroup.ehi.direct-ci.com

Organizations & group practices 3

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1417947904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GOFF MOUNTAIN RD",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131434",
            "telephone_number": "304-776-2072",
            "fax_number": "304-776-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 GOFF MOUNTAIN RD",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131434",
            "telephone_number": "304-776-2072",
            "fax_number": "304-776-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRADIA",
        "first_name": "ARVIND",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "15105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071604000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Lanes, WV

Sources for this page

Verify at the official NPI Registry.