VIRGINIA LYNN CRITELLI MD
NPI 1861454738
Internal Medicine - Gastroenterology in Pensacola, FL

Q: What is Virginia Critelli's NPI number?

The NPI number for Virginia Critelli is 1861454738. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Q: What is Virginia Critelli's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Virginia Critelli was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 05, 2006PECOS EnrolledAccepts Medicare Assignment

1717 NORTH E. STREET, SUITE 401, PENSACOLA, FL 32501(850) 626-9626 Get Directions Write a Review

NPPES record last updated: February 26, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 26, 2021, Sep 17, 2020, Sep 5, 2018 (3 updates tracked since 2018).

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About Virginia Lynn Critelli Md NPPES

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

VIRGINIA LYNN CRITELLI MD (NPI 1861454738) is an individual gastroenterology provider in Pensacola, Florida, licensed in Florida (ME145120) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Baptist Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1861454738

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameVIRGINIA LYNN CRITELLICredential: MD

Location Address1717 NORTH E. STREET, SUITE 401Pensacola, FL 32501

Mailing AddressPo Box 17567Pensacola, FL 32522-7567 · (850) 626-9626

Phone(850) 626-9626

Sole ProprietorNo

Medical School CMSState University Of New York At Buffalo School Of MedicineGraduated 1987

Enumeration DateApril 5, 2006

Last NPPES UpdateFebruary 26, 20213 updates tracked since enumeration

NPPES CertifiedFebruary 26, 2021

✔ NPI 1861454738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in FL · ME145120

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1717 NORTH E. STREET, Pensacola, FL 32501

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Secondary Practice Locations 2

Location 1218 Hospital Dr Ste CBlairsville, GA 30512-3143 · Phone (855) 841-1337 · Fax (855) 841-1338

Location 25671 Peachtree Dunwoody Rd NE, Suite 600Atlanta, GA 30342 · Phone (404) 257-9000 · Fax (404) 847-9792

Other Identifiers 1

Medicaid108030600FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Virginia Lynn Critelli Md 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 ID345288866

PECOS Enrollment IDI20201029001967

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.

Medicare Billing Reassignment

Medicare enrollment records show Virginia Critelli reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baptist Medical Group LLC

0.8 mi

Hematology & Oncology

125 BAPTIST WAY STE 6A
Pensacola, FL 32503

Reassigned Medicare billing, Florida enrollment
241 clinicians in this Medicare group

NPI 1376779892 (448) 227-8053

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

224 services210 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

110 services75 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

102 services99 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

63 services49 patients

Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43255

This procedure involves using a flexible tube with a light, called an endoscope, to examine and treat bleeding in the esophagus, stomach, or upper small bowel. It's a safe, effective way to control bleeding and ensure your digestive health.

40 services37 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

35 services35 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

33 services33 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

17 services17 patients

Diagnostic exam of lower portion of large bowel using a flexible endoscope 45330

This procedure, known as a sigmoidoscopy, involves using a flexible tube with a camera to examine the lower part of your large bowel. It helps in identifying issues like inflammation, ulcers, or abnormal growths. It's a safe, minimally invasive procedure.

12 services12 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

11 services11 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

11 services11 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Baptist Hospital

Acute Care Hospitals · Pensacola, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100093

Location123 Baptist WayPensacola, FL 32503 · Escambia County

Emergency services Birthing friendly

Gulf Breeze Hospital

Acute Care Hospitals · Gulf Breeze, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number100266

Location1110 Gulf Breeze PkwyGulf Breeze, FL 32561 · Santa Rosa County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32501 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

100%498 patients5/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

96%1,218 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%846 patients5/55-star benchmark: 100%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

100%340 patients5/55-star benchmark: 88%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

100%291 patients5/55-star benchmark: 100%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 436 patients

0%436 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Virginia Critelli's NPI number?

The NPI number for Virginia Critelli is 1861454738. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Virginia Critelli located?

Virginia Critelli practices at 1717 North E. Street Suite 401, Pensacola, FL 32501. The listed phone number is (850) 626-9626.

What is Virginia Critelli's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Virginia Critelli enrolled in Medicare?

Yes. Virginia Critelli 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.

Which organization bills Medicare for Virginia Critelli's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Virginia Critelli reassigns Medicare benefits to Baptist Medical Group LLC (Pensacola, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Virginia Critelli's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Virginia Critelli accept?

Health plans from Blue Cross and Blue Shield of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Virginia Critelli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Virginia Critelli affiliated with any hospitals?

According to CMS data, Virginia Critelli is affiliated with Baptist Hospital and Gulf Breeze Hospital.

When was this NPI record last updated?

The NPPES record for Virginia Critelli was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.