Individual provider Active NPI

Todd Feldman, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1639655426
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006444 Issued in VA
Practice address
6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone
(757) 354-2885
Fax
(757) 917-5141
NPI assigned
Jul 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL
Physician Assistant 363A00000X 0110006444 VA Primary

Addresses

Primary practice location

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933

Mailing address

1306 Concourse Dr Ste 201
Linthicum Heights, MD 21090-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181117000200 FL Practitioner - Physician Assistant 9931453511 Reassigns benefits to 2 organizations
I20220415000190 VA Practitioner - Physician Assistant 9931453511 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Observation Physicians of TidewaterGroup PAC ID 8123401429, 19 clinicians

Practice addresses (Care Compare)

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 934-4000

830 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110006444VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 30, 2020 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 30, 2020 Accepting new patients
Integrated Dermatology of Tidewater LLC PastSince Feb 1, 2014 Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Organizations & group practices 8

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 1

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": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1639655426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 CONCOURSE DR STE 201",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210901033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-14",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.