IndividualActiveAccepts Medicare

Taylor D'Etcheverry, PA-C

NPI 1669943890 · Physician Assistant · Charleston, WV

Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1669943890
Entity type: Individual
Primary specialty: Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Credential: PA-C
Sex: Female
Sole proprietor: No
License: 2268 (WV)

Specialties & taxonomies

Physician AssistantPrimary363A00000XLicense 0110009282 (VA)
Physician Assistants & Advanced Practice Nursing Providers
Surgical Critical Care Physician2086S0102XLicense 2268 (WV)
Allopathic & Osteopathic Physicians
Student in an Organized Health Care Education/Training Program390200000X
Student, Health Care

Profile Score

Established profile(57/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
7 yrs in NPPES registry
Profile completeness28% of score
100% of core fields populated
Practice footprint17% of score
4 documented practice locations
Medicare service volume (vs. specialty peers)28% of score
85 Medicare services, 2024 (ranked within specialty)

Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

What this provider does (Medicare)

Based on Medicare fee-for-service claims, 2024; not all care is captured.

Service (HCPCS)	Medicare services	Typical Medicare-allowed (2024)
Harvest of Vein Using an Endoscope33508	36	$2
Coronary Artery Bypass Using Artery Graft, 1 Graft33533	31	$235
Coronary Artery Bypass Using Vein Or Artery Graft, 2 Grafts33518	18	$54

Typical Medicare-allowed amounts for these services range $2–$235 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.

Practice location

3100 Maccorkle Ave Se Ste 101

Charleston, WV 25304-1215

Phone: (304) 388-5395

Approximate (ZIP-level) locationGet directions

More WV providers

Mailing address