Individual provider Active NPI

Gina L. Mitchell, PA-C

  • Surgical Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1851370589
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110840702 Issued in VA
Practice address
500 Martha Jefferson Dr FL 5
Charlottesville, VA 22911
Phone
(434) 654-5260
Fax
(434) 654-5261
NPI assigned
Jan 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110840702 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr FL 5
Charlottesville, VA 22911

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

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
I20050225000189 VA Practitioner - Physician Assistant 7214980606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

Charlottesville, VA 22911

1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110840702VAMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: cnapier246298@direct.sentara.net

Organizations & group practices 1

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 1

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1851370589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR FL 5",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22911",
            "telephone_number": "434-654-5260",
            "fax_number": "434-654-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GINA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110840702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.