Individual provider Active NPI

Shaun Andrew Spadafora, MD

  • Internal Medicine Physician
  • Mechanicsville, VA
National Provider Identifier
1497732143
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101238079 Issued in VA
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 764-6000
NPI assigned
Dec 23, 2005
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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 0101238079 VA Primary

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone (804) 764-6000

Other identifiers 6

IdentifierTypeStateIssuer
1497732143MedicaidVA
302011OtherVAANTHEM
631591OtherVASOUTHERN HEALTH
4667482OtherVACIGNA
186520OtherVAANTHEM BCBS
P00130348OtherVARR MEDICARE

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
I20051201000636 VA Practitioner - Internal Medicine 4587684808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

1602 Skipwith Rd
Richmond, VA 23229-5205
Phone (804) 289-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238079VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Commonwealth Primary Care Past Accepting new patients

Locations

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

7700 E Parham Rd
Richmond, VA 23294
Phone (804) 289-4852

Organizations & group practices 2

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 1

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1497732143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-764-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-764-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADAFORA",
        "first_name": "SHAUN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101238079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497732143",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "302011",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "631591",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4667482",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "186520",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00130348",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.