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NICOLE MAALOUF SHIVELY PA
NPI 1023671617
Physician Assistant in Roanoke, VA

Active since April 18, 2019PECOS EnrolledAccepts Medicare Assignment
1622 WESTOVER AVE SW, ROANOKE, VA 24015(339) 368-1887 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 31, 2024, Apr 3, 2023, Mar 1, 2022 and 2 more (5 updates tracked since 2019).

About Nicole Maalouf Shively Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE MAALOUF SHIVELY PA (NPI 1023671617) is an individual physician assistant in Roanoke, Virginia, licensed in North Carolina (0010-10795) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Medical College Of Virginia Hospitals, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1023671617
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameNICOLE MAALOUF SHIVELYCredential: PA
Location Address1622 WESTOVER AVE SWRoanoke, VA 24015-5216
Mailing Address1622 Westover Ave SwRoanoke, VA 24015-5216 · (339) 368-1887
Phone(339) 368-1887
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateApril 18, 2019
Last NPPES UpdateJuly 31, 20245 updates tracked since enumeration
NPPES CertifiedJuly 31, 2024
✔ NPI 1023671617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-10795
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1622 WESTOVER AVE SW, Roanoke, VA 24015
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Maalouf Shively Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597195917
PECOS Enrollment IDI20240214003758
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Medical College Of Virginia Hospitals

Acute Care Hospitals · Richmond, VA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number490032
LocationPost Office Box 980510 1250 East Marshall StreetRichmond, VA 23298 · Richmond City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Shively's NPI number?

The NPI number for Nicole Shively is 1023671617. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Where is Nicole Shively located?

Nicole Shively practices at 1622 Westover Ave SW, Roanoke, VA 24015. The listed phone number is (339) 368-1887.

What is Nicole Shively's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicole Shively enrolled in Medicare?

Yes. Nicole Shively is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Nicole Shively affiliated with any hospitals?

According to CMS data, Nicole Shively is affiliated with Medical College Of Virginia Hospitals.

When was this NPI record last updated?

The NPPES record for Nicole Shively was last updated on July 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.