MEDICARE: DR. PAUL GEORGE KIRITSIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	101053625	VA
2	207X00000X	Orthopaedic Surgery Physician	0101053625	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	200039105	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	194785	OTHER	VA	ANTHEM WEST END OPERATORY
2	540885859	OTHER	VA	C&O EMPLOYEE'S HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2138281	OTHER	VA	UNITED HEALTHCARE MAMSI
5	540885859	OTHER	VA	COMPMANAGEMENT
6	540885859	OTHER	VA	CIGNA
7	540885859	OTHER	VA	CORVEL
8	0900927	OTHER	VA	UNITED HEALTHCARE
9	2366163	OTHER	VA	AETNA HMO
10	174628	OTHER	VA	ANTHEM HEALTHKEEPERS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	33398	OTHER	VA	SH CARENET
14	289325	OTHER	VA	SOUTHERN HEALTH
15	36596	OTHER	VA	OPTIMA HEALTH
16	540885859	OTHER	VA	FIRST HEALTH/CCN
17	540885859	OTHER	VA	PRIVATE HEALTHCARE SYSTEM
18	540885859	OTHER	VA	FOCUS

General Provider Information

NPI Number	:	1629015094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL GEORGE KIRITSIS M.D.

Provider Business Mailing Address
First Line	:	1115 BOULDERS PKWY
Second Line	:	SUITE 200
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4067
Country	:	US
Telephone Number	:	804-560-5595
Fax Number	:	804-560-9029

Provider Business Practice Location Address
First Line	:	13700 SAINT FRANCIS BLVD
Second Line	:	SUITE 103
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-3267
Country	:	US
Telephone Number	:	804-379-2414
Fax Number	:	804-379-2413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	09/02/2020

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