NPIMap

Individual provider Active NPI

Andrew Lewis Tucker, PA-C

  • Physician Assistant
  • Lynchburg, VA
National Provider Identifier
1740672575
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-004883 Issued in VA
Practice address
1378 Rivermont Ave
Lynchburg, VA 24504-1007
Phone
(434) 610-6803
NPI assigned
Mar 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004883 VA Primary

Addresses

Primary practice location

1378 Rivermont Ave
Lynchburg, VA 24504-1007

Mailing address

1378 Rivermont Ave
Lynchburg, VA 24504-1007
Phone (434) 610-6803

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
I20150428002287 VA Practitioner - Physician Assistant 6608195482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge E N T and P S IncGroup PAC ID 5698872778, 14 clinicians

Practice addresses (Care Compare)

2321 Atherholt Rd
Lynchburg, VA 24501-2113
Phone (434) 947-3993

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.82 of 100Reported as group
Quality
62.5
Promoting interoperability
100
Improvement activities
40
Cost
76.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-004883VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group Southside, LLC Past Accepting new patients

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.

Hospital & facility affiliations 9

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1740672575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041007",
            "telephone_number": "434-610-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 RIVERMONT AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041007",
            "telephone_number": "434-610-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ANDREW",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.