Individual provider Active NPI

Jerita Johanna Dubash, D.O.

  • Psychiatry Physician
  • Blacksburg, VA
National Provider Identifier
1659697126
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0102203899 Issued in VA
Practice address
700 University City Blvd
Blacksburg, VA 24060-2706
Phone
(540) 961-8300
Fax
(540) 961-8465
NPI assigned
Apr 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0102203899 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

700 University City Blvd
Blacksburg, VA 24060-2706

Mailing address

700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 855-1332

Other practice location 1

1902 Braeburn Dr
Salem, VA 24153-7304
Phone (540) 444-0460

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JERITA.DUBASH@hca6.eclinicaldirectplus.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150922000592 VA Practitioner - Psychiatry 5890938187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

25 Northridge LN
Lexington, VA 24450-3387

3831 Westerre Pkwy
Suite 1
Henrico, VA 23233-1330

700 Univeristy City Blvd
Blacksburg, VA 24060-2706

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC CurrentSince Apr 6, 2020 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

1902 Braeburn Dr
Salem, VA 24153
Phone (540) 344-6101

1906 Braeburn Dr
Salem, VA 24153
Phone (540) 444-0460

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1659697126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY CITY BLVD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240602706",
            "telephone_number": "540-855-1332",
            "fax_number": "540-322-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY CITY BLVD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240602706",
            "telephone_number": "540-961-8300",
            "fax_number": "540-961-8465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 Braeburn Dr",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241537304",
            "country_code": "US",
            "telephone_number": "540-444-0460",
            "fax_number": "540-444-0479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBASH",
        "first_name": "JERITA",
        "middle_name": "JOHANNA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102203899",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JERITA.DUBASH@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "700 University City Blvd",
            "city": "Blacksburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240602706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.