Individual provider Active NPI

Anne Marie Mishkofski, P.A.

  • Physician Assistant
  • Suffolk, VA
National Provider Identifier
1891708715
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840363 Issued in VA
Practice address
7185 Harbour Towne Pkwy S Ste 200
Suffolk, VA 23435-3896
Phone
(757) 457-5100
Fax
(757) 961-3696
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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 0110840363 VA Primary
Medical Physician Assistant 363AM0700X 2359 GA

Addresses

Primary practice location

7185 Harbour Towne Pkwy S Ste 200
Suffolk, VA 23435-3896

Mailing address

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100

Other practice location 1

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100

Other identifiers 1

IdentifierTypeStateIssuer
7619200754MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428000097 GA Practitioner - Physician Assistant 4082601455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

275 Collier Rd NW
Suite 500
Atlanta, GA 30309-1711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110840363VAMDPhysician Assistant
2359GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peachatree Cardiovascular & Thoracic Surgeons, P.a. PastSince Jul 23, 1992 Accepting new patients
Cardiology of Georgia Past Accepting new patients
Peachtree Cardiovascular Surgeons at Saint Joseph's LLC Past Accepting new patients
Surgical Assistants of America, Inc. Past Accepting new patients

Organizations & group practices 5

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1891708715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7185 HARBOUR TOWNE PKWY S STE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353896",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Clearfield Ave",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621815",
            "country_code": "US",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISHKOFSKI",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840363",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "2359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7619200754",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.