NPIMap

Individual provider Active NPI

Tiffany Pajic, MSN, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1841684867
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024172440 Issued in VA
Practice address
1300 Mactavish Ave
Richmond, VA 23230-4633
Phone
(804) 997-5900
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024172440 VA Primary

Addresses

Primary practice location

1300 Mactavish Ave
Richmond, VA 23230-4633

Mailing address

1300 Mactavish Ave
Richmond, VA 23230-4633
Phone (804) 997-5900

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
I20170607002331 VA Practitioner - Nurse Practitioner 1052615051 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

2600 Compass Rd
Glenview, IL 60026-8001

8220 Meadowbridge Rd
Suite 101
Mechanicsville, VA 23116-2336
Phone (804) 288-2673

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172440VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC CurrentSince Jun 26, 2017 Accepting new patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Jun 26, 2017 Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients

Locations

8220 Meadowbridge Rd
Ste 101
Mechanicsville, VA 23116
Phone (804) 288-2673

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

7229 Forest Ave
Ste 112
Richmond, VA 23226
Phone (804) 281-0275

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Interoperability endpoints

  • Direct secure messaging: tiffany.pajic@897112813207556.direct.elationemr.com

Organizations & group practices 7

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 6

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1841684867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MACTAVISH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304633",
            "telephone_number": "804-997-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MACTAVISH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304633",
            "telephone_number": "804-997-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJIC",
        "first_name": "TIFFANY",
        "credential": "MSN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024172440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.