Ralph Kenneth Ablaseau, NP-C

Individual provider Active NPI Nurse Practitioner · Williamsburg, VA

NPI 1982869715 · NPPES record last updated Jun 11, 2013

Key facts

NPI
1982869715
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
0024164829 (VA)
Practice address
263 McLaws Circle
Suite 105
Williamsburg, VA 23185-5629
Phone
(757) 941-5600
Fax
(757) 564-0557
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfield Psychological Assoc. (9 clinicians)

Practice addresses (Care Compare)

5265 Providence Rd
Suite 500
Virginia BCH, VA 23464-4210
Phone (757) 467-9500

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110921000431 VA Practitioner - Nurse Practitioner 1658542733 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0024164829VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Psychological Assoc. Current
since Jan 1, 2021
Accepting new patients
Gli LLC Current
since Aug 9, 2011
Accepting new patients

Locations

1021 Eden Way N
Chesapeake, VA 23320
Phone (434) 203-9097

1021 Eden Way N
Ste 124
Chesapeake, VA 23320
Phone (757) 842-6757

2901 S Lynnhaven Rd
Ste 170
Virginia Beach, VA 23452
Phone (757) 498-5714

5265 Providence Rd
Ste 500
Virginia Beach, VA 23464
Phone (757) 354-5379

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024164829 VA
Nurse Practitioner 363L00000X 0024164829 VA Yes

Addresses

Primary practice location

263 McLaws Circle
Suite 105
Williamsburg, VA 23185-5629

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Other identifiers

IdentifierTypeStateIssuer
-032OtherVATRICARE/CHAMPUS
1982869715MedicaidVA
PAROtherVAUSA MANAGED CARE
PAROtherVAMULTIPLAN
PAROtherVACORVEL

Other providers in Williamsburg, VA

All providers in Williamsburg, VA · Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.