Individual provider Active NPI

Robert J Trimarche, PA-C

  • Physician Assistant
  • Forest, VA
National Provider Identifier
1811904006
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004190 Issued in VA
Practice address
1019 Vista Park Dr
Ste a
Forest, VA 24551-4901
Phone
(434) 200-9009
Fax
(434) 200-9005
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 104127 NC
Physician Assistant 363A00000X 0110004190 VA Primary

Addresses

Primary practice location

1019 Vista Park Dr
Ste a
Forest, VA 24551-4901

Mailing address

1019 Vista Park Dr
Ste a
Forest, VA 24551-4901
Phone (434) 200-9009

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000719 VA Practitioner - Physician Assistant 6800852831 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104127NCMDPhysician Assistant
0110004190VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Dec 23, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Dec 23, 2016 Accepting new patients
Centra Medical Group, LLC CurrentSince Apr 29, 2013 Accepting new patients
Centra Health Professional Services, LLC CurrentSince Apr 29, 2013 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

2103 Graves Mill Rd
Forest, VA 24551
Phone (434) 316-7190

1019 Vista Park Dr
Ste A
Forest, VA 24551
Phone (434) 200-9009

2019 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 845-7035

2215 Landover Pl
Lynchburg, VA 24501
Phone (434) 947-3900

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: addictionallies.roberttrimarche@150196.advancedmd-direct.com

Organizations & group practices 6

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1811904006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 VISTA PARK DR",
            "address_2": "STE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514901",
            "telephone_number": "434-200-9009",
            "fax_number": "434-200-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 VISTA PARK DR",
            "address_2": "STE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514901",
            "telephone_number": "434-200-9009",
            "fax_number": "434-200-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMARCHE",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104127",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.