Eastlake Primary Care PC
NPI 1043002934ActiveOrganization· Family Medicine· Moneta, VA
Family Medicine in Moneta, Virginia, registered in NPPES in May 2025. The authorized official on file is Holly Hullett Roy, PA-C, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1043002934 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 19, 2025 |
| Last updated in NPPES | Feb 25, 2026 |
| Certified by provider | Feb 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (VA) |
|---|
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