NPIMap

Individual provider Active NPI

Daniel Marcial Chavez Andia, MD

  • Internal Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1598325359
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2019018162 Issued in MO
Practice address
222 S Woods Mill Rd
Chesterfield, MO 63017-3625
Phone
(314) 205-6050
Fax
(314) 434-5939
NPI assigned
Jun 14, 2019
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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 2019018162 MO Primary

Addresses

Primary practice location

222 S Woods Mill Rd
Chesterfield, MO 63017-3625

Mailing address

222 S Woods Mill Rd
Chesterfield, MO 63017-3625
Phone (314) 205-6050

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
I20220802002826 VA Practitioner - Internal Medicine 2062894405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Hampton Roads Primary Care LLCGroup PAC ID 0941632756, 62 clinicians

Practice addresses (Care Compare)

3537 Airline Blvd
Suite 1
Portsmouth, VA 23701-2650
Phone (757) 738-1225

930 W 21St St
Suite 100
Norfolk, VA 23517-1516
Phone (757) 622-8358

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019018162MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Primary Care LLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

3537 Airline Blvd
Ste 1
Portsmouth, VA 23701
Phone (757) 738-1225

Interoperability endpoints

  • Direct secure messaging: dchavezandia1327835@direct.bsmhealth.org

Organizations & group practices 1

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 11

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1598325359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-205-6050",
            "fax_number": "314-434-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-205-6050",
            "fax_number": "314-434-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ ANDIA",
        "first_name": "DANIEL",
        "middle_name": "MARCIAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2019018162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.