Individual provider Active NPI

Stephanie Kwasniewski, PA-C

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1417984675
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001816 Issued in VA
Practice address
8040 W Broad St
Richmond, VA 23294-4218
Phone
(804) 346-0927
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103991 NC
Physician Assistant 363A00000X 0110001816 VA Primary

Addresses

Primary practice location

8040 W Broad St
Richmond, VA 23294-4218

Mailing address

423 Fortress Boulevard
Morgantown, WV 26508
Phone (304) 225-2500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040527000953 VA Practitioner - Physician Assistant 7315928066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

104 Carolina Ave
Brookneal, VA 24528-2643
Phone (434) 376-2325

16890 Forest Rd
Forest, VA 24551-4059
Phone (434) 200-7210

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

291 McBride LN
Gretna, VA 24557-2773
Phone (434) 656-1274

915 S Main St
Farmville, VA 23901-2211
Phone (434) 414-3978

935 S Main St
Farmville, VA 23901-2211
Phone (434) 315-5340

Hospital & facility affiliations

  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103991NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince May 1, 2024 Accepting new patients
Williamsburg Emergency Physicians CurrentSince Jul 1, 2016 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Nov 16, 2019 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Nov 16, 2019 Accepting new patients
Centra Health Professional Services, LLC CurrentSince May 1, 2024 Accepting new patients
Loon Emergency Physicians LLC Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients

Locations

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

1280A Main St
Altavista, VA 24517
Phone (434) 309-1165

1613 Oakwood St
Ste 201
Bedford, VA 24523
Phone (540) 586-4723

104 Carolina Ave
Brookneal, VA 24528
Phone (434) 376-2325

412 Namozine St
Burkeville, VA 23922
Phone (434) 767-4822

414 Park Ave
Danville, VA 24541
Phone (434) 791-4892

65 Brickyard Dr
Dillwyn, VA 23936
Phone (434) 414-1021

935 S Main St
Farmville, VA 23901
Phone (434) 315-5340

16890 Forest Rd
Forest, VA 24551
Phone (434) 200-7210

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

291 McBride Ln
Gretna, VA 24557
Phone (434) 200-4030

312 King St
Keysville, VA 23947
Phone (434) 315-2920

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

125 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 200-3908

4830 Rucker Rd
Moneta, VA 24121
Phone (540) 297-7181

8040 W Broad St
Richmond, VA 23294
Phone (804) 346-0927

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

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

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 7

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1417984675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BOULEVARD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26508",
            "telephone_number": "304-225-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232944218",
            "telephone_number": "804-346-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWASNIEWSKI",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103991",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.