Individual provider Active NPI

Pamela M Mancini, MD

  • Pediatrics Physician
  • Fredericksburg, VA
National Provider Identifier
1902892292
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101043865 Issued in VA
Practice address
4550 Empire CT
Fredericksburg, VA 22408-1939
Phone
(540) 361-1800
Fax
(540) 361-1803
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101043865 VA Primary

Addresses

Primary practice location

4550 Empire CT
Fredericksburg, VA 22408-1939

Mailing address

4550 Empire CT
Fredericksburg, VA 22408-1939
Phone (540) 361-1800

Other identifiers 1

IdentifierTypeStateIssuer
6721303MedicaidVA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211000137 VA Practitioner - Pediatric Medicine 4587760350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101043865VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PL Physicians, Inc. Pediatrics CurrentSince Sep 13, 2014 Accepting new patients
PL Pediatrics, PLLC Pediatrics CurrentSince Sep 13, 2014 Accepting new patients

Locations

4550 Empire Ct
Fredericksburg, VA 22408
Phone (540) 361-1800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1902892292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EMPIRE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081939",
            "telephone_number": "540-361-1800",
            "fax_number": "540-361-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EMPIRE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081939",
            "telephone_number": "540-361-1800",
            "fax_number": "540-361-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "PAMELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101043865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6721303",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.