Individual provider Active NPI

Marc Philip Breidenbaugh, MD

  • Allergy & Immunology Physician
  • Charlottesville, VA
National Provider Identifier
1700346764
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101274577 Issued in VA
Practice address
1415 Rolkin CT Ste 102
Charlottesville, VA 22911-3643
Phone
(434) 951-2191
Fax
(434) 977-0200
NPI assigned
Mar 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 0101274577 VA Primary

Addresses

Primary practice location

1415 Rolkin CT Ste 102
Charlottesville, VA 22911-3643

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

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
I20240828005206 VA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 1456688415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Virginia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richmond Allergy and Asthma Specialists,PCGroup PAC ID 0143307207, 6 clinicians

Practice addresses (Care Compare)

9920 Independence Park Dr
Suite 100
Henrico, VA 23233-1487
Phone (804) 285-7420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101274577VAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Allergy and Asthma Specialists,PC CurrentSince Jul 10, 2024 Accepting new patients
Inova Health Care Services Pediatrics PastSince Jul 10, 2024 Accepting new patients

Locations

9920 Independence Park Dr
Ste 100
Richmond, VA 23233
Phone (804) 285-7420

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1700346764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROLKIN CT STE 102",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113643",
            "telephone_number": "434-951-2191",
            "fax_number": "434-977-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREIDENBAUGH",
        "first_name": "MARC",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101274577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.