NPIMap

Individual provider Active NPI

Paul Carpenter Maccarty I

  • Physician Assistant
  • South Boston, VA
National Provider Identifier
1649840208
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008116 Issued in VA
Practice address
4157 River Rd
South Boston, VA 24592-6017
Phone
(434) 572-7908
NPI assigned
Jun 28, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0110008116 VA Primary

Addresses

Primary practice location

4157 River Rd
South Boston, VA 24592-6017

Mailing address

4157 River Rd
South Boston, VA 24592-6017
Phone (434) 572-7908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211213002511 VA Practitioner - Physician Assistant 8921498528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

800 Oak St
Farmville, VA 23901-1199
Phone (434) 315-2998

915 S Main St
Farmville, VA 23901-2211
Phone (434) 414-3978

935 S Main St
Farmville, VA 23901-2211
Phone (434) 315-5340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110008116VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Oct 18, 2021 Accepting new patients

Locations

125 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 200-3908

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6484

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1649840208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 RIVER RD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245926017",
            "telephone_number": "434-572-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 RIVER RD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245926017",
            "telephone_number": "434-572-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCARTY",
        "first_name": "PAUL",
        "middle_name": "CARPENTER",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.