NPIMap

Individual provider Active NPI

Samuel Olds, PA-C

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1538645189
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006282 Issued in VA
Practice address
415 Ray C Hunt Dr FL 2
Charlottesville, VA 22903-2980
Phone
(434) 924-5700
Fax
(434) 924-1736
NPI assigned
Jul 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006282 VA Primary

Addresses

Primary practice location

415 Ray C Hunt Dr FL 2
Charlottesville, VA 22903-2980

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-2980
Phone (434) 924-0211

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address solds417403@direct.healthsystem.virginia.edu Direct

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
I20181001003473 VA Practitioner - Physician Assistant 0941551907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816

415 Ray C Hunt Dr
Charlottesville, VA 22903-2980

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 1, 2018 Accepting new patients

Locations

652 Peter Jefferson Pkwy
Ste 140
Charlottesville, VA 22911
Phone (434) 243-9415

415 Ray C Hunt Dr
Fl 2
Charlottesville, VA 22903
Phone (434) 243-0223

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Interoperability endpoints

  • Direct secure messaging: solds417403@direct.healthsystem.virginia.edu

Organizations & group practices 6

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.

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": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1538645189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 RAY C HUNT DR FL 2",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032980",
            "telephone_number": "434-924-5700",
            "fax_number": "434-924-1736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082980",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDS",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "solds417403@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "415 Ray C Hunt Dr Fl 2",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229032980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.