Joseph McIlvaine, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1060 W Perimeter Rd Ste 3K43
JB Andrews, MD 20762-6602

Phone

(888) 999-1212

NPI assigned

Mar 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1871097717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD STE 3K43",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "888-999-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Capehart Rd",
            "address_purpose": "LOCATION",
            "city": "Offutt AFB",
            "state": "NE",
            "postal_code": "681131043",
            "country_code": "US",
            "telephone_number": "318-456-2380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCILVAINE",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871097717",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Wescott Mahoney, MD
• Malcolm Grow Medical Center
• Meaghan McCarthy, IDMT
• Sandra L McCatty, MD
• Kyle Park McClain, DO
• Staci McNair
• Lance McNaughton, O.D., PH.D.
• Timothy Michael McSheehy, IDMT
• Jeremy Zane Melendez, PA-C
• Etsegenet Abebe Molla, DMD

• Medical Physician Assistant in JB Andrews, MD
• Providers in JB Andrews, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.