Individual provider Active NPI

Niccole Marie Snyder, PA

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1609219856
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1031 Loftis Blvd
Suite 100
Newport News, VA 23606-2981
Phone
(757) 736-9860
Fax
(757) 240-5537
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 Primary

Addresses

Primary practice location

1031 Loftis Blvd
Suite 100
Newport News, VA 23606-2981

Mailing address

1031 Loftis Blvd
Suite 100
Newport News, VA 23606-2981
Phone (757) 736-9860

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
I20130916000760 VA Practitioner - Physician Assistant 0840434783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1101 1St Colonial Rd
Suite 300
Virginia Beach, VA 23454-2409
Phone (757) 388-6005

2075 Glenn Mitchell Dr
Virginia Beach, VA 23456-0179

301 Riverview Ave
Norfolk, VA 23510-1065

713 Volvo Pksy
Ste. 200
Chesapeake, VA 23320-1614
Phone (757) 282-4150

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

844 Kempsville Rd
Norfolk, VA 23502-3927

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Aug 12, 2013 Accepting new patients

Locations

1031 Loftis Blvd
Ste 100
Newport News, VA 23606
Phone (757) 736-9860

844 Kempsville Rd
Ste 204
Norfolk, VA 23502
Phone (757) 261-0700

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Interoperability endpoints

  • Direct secure messaging: nsnyder58862@direct.sentara.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1609219856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 LOFTIS BLVD",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062981",
            "telephone_number": "757-736-9860",
            "fax_number": "757-240-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 LOFTIS BLVD",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062981",
            "telephone_number": "757-736-9860",
            "fax_number": "757-240-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "NICCOLE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.