Matiyaga Ramirez Jardiniano, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110840340 Issued in VA

Practice address

4844 Berrywood Rd.
VA. Beach, VA 23464-5871

Phone

(757) 962-0778

NPI assigned

Aug 17, 2011

Last updated

Jan 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Medical Center I Inc

  dba Doctors ON Call

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1073524484
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1861772295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 BERRYWOOD RD.",
            "city": "VA. BEACH",
            "state": "VA",
            "postal_code": "234645871",
            "telephone_number": "757-962-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 BERRYWOOD RD.",
            "city": "VA. BEACH",
            "state": "VA",
            "postal_code": "234645871",
            "telephone_number": "757-962-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINIANO",
        "first_name": "MATIYAGA",
        "middle_name": "RAMIREZ",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• House of Angels (DBA Angel House)
• I See Optical
• Ict Services, Inc.
• Indpendent Voices Adult Livingllc (Indpendent Voices Day Support)
• J&C Healthcare Services LLC
• Michelle Marie Jenkins
• Carrie Elizabeth Jones, FNP-C
• Matthew H Jones, M.D.
• Tysheena Lanee Jones, NP-C
• Stephen Jurko, DO

• Medical Physician Assistant in VA Beach, VA
• Providers in VA Beach, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.