Individual provider Active NPI

Jason Alexander Shugoll, MD

  • Psychiatry Physician
  • Charlottesville, VA
National Provider Identifier
1619554268
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101280026 Issued in VA
Practice address
630 Peter Jefferson Pkwy Ste 130
Charlottesville, VA 22911-4624
Phone
(434) 201-2155
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101280026 VA Primary

Addresses

Primary practice location

630 Peter Jefferson Pkwy Ste 130
Charlottesville, VA 22911-4624

Mailing address

1215 Lee St
Mail Stop 801210
Charlottesville, VA 22908-0816
Phone (434) 924-5314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250717000069 DC Practitioner - Psychiatry 3476954744 Reassigns benefits to 1 organization
I20250908000168 VA Practitioner - Psychiatry 3476954744 Reassigns benefits to 1 organization
I20260222000013 MD Practitioner - Psychiatry 3476954744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Associates of Maryland LLCGroup PAC ID 3971550963, 151 clinicians

Practice addresses (Care Compare)

120 Sister Pierre Dr
Suite 403
Towson, MD 21204-7536
Phone (410) 823-6408

139 N Main St
Suite 101
Bel Air, MD 21014-8844
Phone (667) 668-2566

630 Peter Jefferson Pkwy
Suite 130
Charlottesville, VA 22911-4624
Phone (703) 812-4642

7700 E Parham Rd
Richmond, VA 23294-4301
Phone (703) 812-4642

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101280026VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Associates of Maryland LLC Psychiatry CurrentSince Jul 1, 2025 Accepting new patients
Neta, Inc. PastSince Jan 21, 2020 Accepting new patients

Locations

124 N Main St
Ste C
Berlin, MD 21811
Phone (410) 641-4598

4520 East West Hwy
Ste 775
Bethesda, MD 20814
Phone (240) 531-2799

2331 York Rd
Ste 100
Timonium, MD 21093

120 Sister Pierre Dr
Ste 403
Towson, MD 21204

630 Peter Jefferson Pkwy
Ste 130
Charlottesville, VA 22911
Phone (434) 201-2155

7700 E Parham Rd
Richmond, VA 23294
Phone (804) 289-4852

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1619554268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "MAIL STOP 801210",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-5314",
            "fax_number": "434-243-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY STE 130",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114624",
            "telephone_number": "434-201-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUGOLL",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101280026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.