Individual provider Active NPI

Antonnette Villaflor-Zitouni, PA C

  • Medical Physician Assistant
  • Norfolk, VA
National Provider Identifier
1609932318
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002435 Issued in VA
Practice address
721 Fairfax Ave
3Rd Floor
Norfolk, VA 23507-2007
Phone
(757) 446-5915
Fax
(757) 446-5969
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002435 VA Primary

Addresses

Primary practice location

721 Fairfax Ave
3Rd Floor
Norfolk, VA 23507-2007

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5915

Other identifiers 8

IdentifierTypeStateIssuer
-017OtherVATRICARE/CHAMPUS
PAROtherVAMULTIPLAN
PAROtherVAUSA MANAGED CARE
10019320POtherVASENTARA/OPTIMA
1609932318MedicaidVA
8101070MedicaidNC
10014991POtherVASENTARA OPTIMA
PAROtherVACORVEL/CORCARE

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
I20070423000588 VA Practitioner - Physician Assistant 1052416898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904

721 Fairfax Ave
Norfolk, VA 23507-2007

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002435VAMDMedical Physician Assistant

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 2

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1609932318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5915",
            "fax_number": "757-446-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAIRFAX AVE",
            "address_2": "3RD FLOOR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235072007",
            "telephone_number": "757-446-5915",
            "fax_number": "757-446-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAFLOR-ZITOUNI",
        "first_name": "ANTONNETTE",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-017",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "10019320P",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609932318",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101070",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA OPTIMA",
            "identifier": "10014991P",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORCARE",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.