MARK A PAVILACK


Address: 3235 Academy Ave, Suite 200, Portsmouth, VA 23703-3200
Phone: 7574830400

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207W00000X Ophthalmology 0101232985 VA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA 1245238096 05
VA ANTHEM 247538 01
VA 6309909 05

Office Location

Street Address 3235 ACADEMY AVE
SUITE 200
City PORTSMOUTH
State VA
Zip Code 23703-3200

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207W00000X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City PORTSMOUTH
Zip Code 23703

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Dataset Information

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.

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