NPIMap

Individual provider Active NPI

Amy Anne Vasilakis-Donzella, DO

  • Family Medicine Physician
  • Wheeling, WV
National Provider Identifier
1619960176
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1899 Issued in WV
Practice address
1315 Mt. Dechantal Road
Wheeling, WV 26003-6392
Phone
(304) 243-7117
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1899 WV Primary

Addresses

Primary practice location

1315 Mt. Dechantal Road
Wheeling, WV 26003-6392

Mailing address

1315 Mt. Dechantal Road
Wheeling, WV 26003-6392
Phone (304) 243-7117

Other identifiers 6

IdentifierTypeStateIssuer
2410064MedicaidOH
1899OtherHEALTH PLAN OF UPPER OH V
21502391100OtherOHOHIO BWC
001718181OtherMOUNTAIN STATE BCBS
55035705700OtherWVWV COMPENSATION
1809463000MedicaidWV

Other names 1

  • Amy Anne Vasilakis-Donzella Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20070328000400 WV Practitioner - Family Practice 8022112234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Family Practice, PLLCGroup PAC ID 9436253630, 4 clinicians

Practice addresses (Care Compare)

1315 Mt Dechantal Rd
Wheeling, WV 26003-6357
Phone (304) 243-7117

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Practice, PLLC Family Medicine CurrentSince Apr 1, 2007 Accepting new patients
Alecto Healthcare Services Wheeling LLC Past Accepting new patients
Ohio Valley Medical Center Inc Family Medicine PastSince Apr 1, 2007 Accepting new patients

Locations

1315 Mount de Chantal Rd
Wheeling, WV 26003
Phone (304) 243-6420

Interoperability endpoints

  • Direct secure messaging: dramyvasilakis@afp.medentdirect.com

Organizations & group practices 3

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 7

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1619960176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MT. DECHANTAL ROAD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-243-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MT. DECHANTAL ROAD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-243-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILAKIS-DONZELLA",
        "first_name": "AMY",
        "middle_name": "ANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2410064",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF UPPER OH V",
            "identifier": "1899",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC",
            "identifier": "21502391100",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001718181",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV COMPENSATION",
            "identifier": "55035705700",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1809463000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "VASILAKIS-DONZELLA",
            "middle_name": "ANNE",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.