Elvis R. Sierra, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002708 Issued in VA

Practice address

6501 Mechanicsville Tpke Ste G1
Mechanicsville, VA 23111-3698

Phone

(804) 522-1501

Fax

(804) 522-1502

NPI assigned

Jul 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD (past)

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1508065764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 CREIGHTON PKWY",
            "address_2": "SUITE C, #132",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231114594",
            "telephone_number": "804-522-1501",
            "fax_number": "804-522-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 MECHANICSVILLE TPKE STE G1",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113698",
            "telephone_number": "804-522-1501",
            "fax_number": "804-522-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "ELVIS",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Susan Shriver
• Ian S Shupack, M.D.
• Connie Shupe, PT
• Logan Shuping, PT, DPT
• Melissa Siebert
• Timothy M. Silver, M.D.
• Charles Silvers, LPTA
• Marjoria Simms, ACP
• Barry Faryl Simon, ATHLETIC TRAINER
• Alexis Marie Simpson, FNP-BC

• Physician Assistant in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.