Mandria L Fuqua, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002029 Issued in VA

Practice address

2137 Lakeside Dr
Suite 100
Lynchburg, VA 24501-6806

Phone

(434) 385-4184

Fax

(434) 385-8616

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: mandria.fuqua.2@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment Care Compare group NPD
• Central Virginia Family Physicians, Inc. Laboratory

  • Clinical Medical Laboratory
  • Lynchburg, VA
  • NPI 1083992523
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centra Health Inc

  • General Acute Care Hospital
  • Lynchburg, VA
  • NPI 1770693939
  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba Centra Health Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1407884448

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • Lynchburg, VA
  • NPI 1811925852

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Wound Care Center

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
  • NPI 1902834948

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba CMG Vascular Surgery

  • Vascular Surgery Physician
  • Lynchburg, VA
  • NPI 1144880782

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Medical Group Stroobants Cardiovascular Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1184964124

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Lynchburg Hematology and Oncology

  • Hematology & Oncology Physician
  • Lynchburg, VA
  • NPI 1700293628

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1760483697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 LAKESIDE DR",
            "address_2": "SUITE 100",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016806",
            "telephone_number": "434-385-4184",
            "fax_number": "434-385-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 LAKESIDE DR",
            "address_2": "SUITE 100",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016806",
            "telephone_number": "434-385-4184",
            "fax_number": "434-385-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "MANDRIA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "104177",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Fulcher
• Carisma Denisha Fuller
• Jeffrey Alan Fulmer, LCSW
• Susan Funk, MD
• Alisa Funke, MD
• Angelina Renee Fusco
• Emily Gabel, PA-C
• Jacob Gachowski
• William P Gada, MD
• Ashwini Gadalay, MD

• Physician Assistant in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.