MARK A PAVILACK (NPI# 1245238096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245238096 |
| Entity Type | Individual |
| Full Name | MARK A PAVILACK |
| Credential | MD |
| Practice Address |
3235 Academy Ave Suite 200 Portsmouth VA 23703-3200 |
| Practice Telephone | 7574830400 |
| Mailing Telephone | 7574830400 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2013-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 0101232985 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1245238096 | 05 | |
| VA | ANTHEM | 247538 | 01 |
| VA | 6309909 | 05 |
| Street Address |
3235 ACADEMY AVE SUITE 200 |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23703-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346470572 | Nancy D Myers | Physician Assistant | 3235 Academy Ave, Suite 101, Portsmouth, VA 23703-3200 | 2009-07-22 |
| 1245469964 | Tidewater Eye Centers | Ophthalmology | 3235 Academy Ave, Suite 200, Portsmouth, VA 23703-3200 | 2009-07-02 |
| 1871732784 | Churchland Family Medicine PC | Family Medicine | 3235 Academy Ave, Suite 102, Portsmouth, VA 23703-3200 | 2009-02-17 |
| 1235393059 | Krunal Manubhai Patel | Internal Medicine | 3235 Academy Ave, Suite 301, Portsmouth, VA 23703-3200 | 2008-07-10 |
| 1265691141 | Kori A Elkins | Ophthalmology | 3235 Academy Ave, Suite 200, Portsmouth, VA 23703 | 2008-06-05 |
| 1942488564 | Digitrace Care Services Inc | Durable Medical Equipment & Medical Supplies | 3235 Academy Ave, Suite 304, Portsmouth, VA 23703-3200 | 2008-02-06 |
| 1578750584 | Karen Diane Kahan | Nurse Practitioner | 3235 Academy Ave, Suite 305, Portsmouth, VA 23703-3200 | 2007-10-03 |
| 1548466238 | Digitrace Care Services Inc | Durable Medical Equipment & Medical Supplies | 3235 Academy Ave, Suite 304, Portsmouth, VA 23703-3200 | 2007-06-21 |
| 1083731525 | Jeffrey Stephen Wolf | Colon & Rectal Surgery | 3235 Academy Ave, Suite 200, Portsmouth, VA 23703-3200 | 2007-03-22 |
| 1326177056 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 3235 Academy Ave, Suite 304, Portsmouth, VA 23703-3200 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174037444 | Kelly Foster | Massage Therapist | 3108 Tyre Neck Rd Ste D, Portsmouth, VA 23703 | 2017-11-25 |
| 1578072104 | Katherine Armstrong Wise | Behavior Technician | 3120 Verne Ave, Portsmouth, VA 23703 | 2017-09-27 |
| 1891223913 | Ashley Rebecca Anderson | Dentist | 5915 High Street W, Portsmouth, VA 23703 | 2017-06-02 |
| 1881126019 | Anas Elmahdi | Specialist | 5205 Sweetbriar C., 5205 Sweetbriar C., Portsmouth, VA 23703 | 2017-03-28 |
| 1578003554 | Elyse Buttery | Nurse Practitioner | Mast One 1040 University Blvd, Suite 200, Portsmouth, VA 23703 | 2017-02-24 |
| 1376948349 | Charles Douglas Knight | Military Health Care Provider | Uss Maryland Ssbn 738, Fpo, AA 23703 | 2014-11-03 |
| 1689929382 | Positive Connections, Inc | Community/Behavioral Health | 3823d Meherrin River Reach, Portsmouth, VA 23703 | 2012-07-18 |
| 1225319874 | Sanaz Namin | Pharmacist | 5601 High Street, Porstmouth, VA 23703 | 2011-09-08 |
| 1295029767 | Maggie Jackson | Dental Hygienist | 4000 Coast Guard Blvd., Portsmouth, VA 23703 | 2011-06-02 |
| 1679804892 | Amy Kathleenn Gaspar | Specialist/Technologist, Other | 4113 Pendleton Rd, Portsmouth, VA 23703 | 2010-01-28 |
| Find all providers in zip 23703 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770840365 | Kinley Danae Beck | Ophthalmology | 155 Borthwick Ave Ste 200e, Portsmouth, NH 03801-4184 | 2012-04-19 |
| 1154550879 | Tidewater Eye Centers | Ophthalmology | 3235 Academy Ave Ste 200, Portsmouth, VA 23703 | 2009-07-02 |
| 1417074311 | Kyle Eric Miller | Ophthalmology | Naval Medical Center Portsmouth - Staff Mail, 620 John Paul Jones Cr, Portsmouth, VA 23708 | 2007-03-23 |
| 1225085251 | Jay Egolf | Ophthalmology | 1400 Gay St, Portsmouth, OH 45662-3475 | 2006-05-27 |
| 1558338749 | Northwest Corneal Consultants Pa | Ophthalmology | 155 Griffin Rd, Portsmouth, NH 03801-4125 | 2006-03-07 |
| 1295701985 | Richard J Lasonde | Ophthalmology | 155 Griffin Road, Portsmouth, NH 03801-4125 | 2006-02-23 |
| 1386646644 | John Denoon Evans | Ophthalmology | 1534 11th St, Portsmouth, OH 45662-4524 | 2005-06-01 |
| 1891016796 | Ian Chauncey Uber | Ophthalmology | 620 John Paul Jones Cir, Portsmouth, VA 23708 | 2010-06-15 |
| 1538486717 | Timothy W Sullivan | Ophthalmology | 155 Borthwick Ave, Suite 200 E, Portsmouth, NH 03801-7156 | 2010-04-27 |
| 1497071096 | Claudia Emerson Bartolini | Ophthalmology | 155 Borthwick Ave, Suite 200 East, Portsmouth, NH 03801-7156 | 2010-04-08 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 23703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.