NPIMap

Individual provider Active NPI

Angela Lynn Ettinger

  • Medical Physician Assistant
  • Winchester, VA
National Provider Identifier
1932497419
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004093 Issued in VA
Practice address
190 Campus Blvd,
Ste. 300
Winchester, VA 22601
Phone
(540) 667-1244
Fax
(540) 667-3086
NPI assigned
Jul 18, 2011
Last updated
Mar 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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 01560 WV
Medical Physician Assistant 363AM0700X 0110004093 VA Primary

Addresses

Primary practice location

190 Campus Blvd,
Ste. 300
Winchester, VA 22601

Mailing address

190 Campus Blvd Ste 300
Winchester, VA 22601-2872
Phone (540) 667-1244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110823000761 WV Practitioner - Physician Assistant 0941470314 Reassigns benefits to 2 organizations
I20260210003573 VA Practitioner - Physician Assistant 0941470314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

2000 Foundation Way
Martinsburg, WV 25401-9198

650 Cedar Creek Grade
Suite 100
Winchester, VA 22601-6453
Phone (540) 535-0000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01560WVMDPhysician Assistant
0110004093VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
University Hematology and Oncology CurrentSince Jan 1, 2023 Accepting new patients
University Healthcare Physicians, Inc. Physician Assistant CurrentSince Oct 21, 2013 Accepting new patients
Garrison V. Morin Dba Mountain State ENT Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

920 N Shenandoah Ave
Ste 202
Front Royal, VA 22630
Phone (540) 535-0000

650 Cedar Creek Grade
Ste 100
Winchester, VA 22601
Phone (540) 535-0000

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

  • FHIR API: https://apps.mywvuchart.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1932497419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 300",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-1244",
            "fax_number": "540-667-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD,",
            "address_2": "STE. 300",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-667-1244",
            "fax_number": "540-667-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01560",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.