Individual provider Active NPI

Andrew P. Metinko, M.D.

  • Pediatric Critical Care Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1740279603
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
0101243636 Issued in VA
Practice address
Lee St FL 7
Charlottesville, VA 22908-0001
Phone
(434) 924-1701
Fax
(434) 924-5244
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MD424916L PA
Pediatric Critical Care Medicine Physician 2080P0203X 0101243636 VA Primary

Addresses

Primary practice location

Lee St FL 7
Charlottesville, VA 22908-0001

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other identifiers 1

IdentifierTypeStateIssuer
1740279603MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000924 PA Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 0143254433 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD424916LPAMDPediatric Critical Care Medicine Physician
0101243636VAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Apr 11, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Apr 11, 2017 Accepting new patients
Children'S Hospital Past Accepting new patients

Locations

3551 N Broad St
Philadelphia, PA 19140
Phone (215) 430-4000

Interoperability endpoints

  • Direct secure messaging: hscametink@yourcarecommunity.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1740279603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LEE ST FL 7",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-1701",
            "fax_number": "434-924-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METINKO",
        "first_name": "ANDREW",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD424916L",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "VA",
            "license": "0101243636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740279603",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.