| Nickolas L Pezzella, MD | |
|
2012 Meade Pkwy, Suffolk, VA 23434-4259 | |
| (757) 538-0102 | |
| (757) 538-1833 |
| Full Name | Nickolas L Pezzella |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 30 Years |
| Location | 2012 Meade Pkwy, Suffolk, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932129475 | NPI | - | NPPES |
| P00799764 | Other | VA | RR MEDICARE |
| 250011832 | Other | VA | MEDICARE RR |
| 006800688 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 0101057162 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bon Secours Maryview Medical Center | Portsmouth, VA | Hospital |
| Southampton Memorial Hospital | Franklin, VA | Hospital |
| Riverside Regional Medical Center | Newport news, VA | Hospital |
| Sentara Obici Hospital | Suffolk, VA | Hospital |
| Sentara Norfolk General Hospital | Norfolk, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bon Secours Medical Group Hampton Roads Specialty Care Llc | 3173955671 | 159 |
| Proactive Therapy Of North Carolina Inc | 6305753120 | 153 |
| Entity Name | Bon Secours Medical Group Hampton Roads Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629637475 PECOS PAC ID: 3173955671 Enrollment ID: O20191122000258 |
| Mailing Address | Practice Location Address |
|---|---|
| Nickolas L Pezzella, MD 2012 Meade Pkwy, Suffolk, VA 23434-4259 Ph: (757) 538-0102 | Nickolas L Pezzella, MD 2012 Meade Pkwy, Suffolk, VA 23434-4259 Ph: (757) 538-0102 |
Dahlia Johnson, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 162 Squire Reach, Suffolk, VA 23434 Phone: 757-404-7540 | |
William Hernandez, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 2580 Pruden Blvd, Suffolk, VA 23434 Phone: 757-934-2363 | |
Dr. Kimberley Jordan Atkins, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 3034 Silver Charm Cir, Suffolk, VA 23435 Phone: 757-374-6943 | |
Joseph Andrie Saveika Iii, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 2000 Meade Pkwy, Suffolk, VA 23434 Phone: 757-539-0251 Fax: 757-934-9409 |