Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carissa Lynn Pardekooper, PA-C

Individual provider Physician Assistant · NPI 1063815017

Carissa Lynn Pardekooper, PA-C is a Physician Assistant in Hampton, Virginia. Qualified in 2014, 12 years ago. Accepts Medicare assignment. Licensed in Illinois and Virginia.

Years since qualifying
12
Licensed in
IL, VA
In the registry since
2014
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2240 Coliseum Dr Ste D
Hampton, VA 23666-5903
Phone: (888) 321-7170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008037 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 085005227 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 081387

Record details

NPI number1063815017
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 6, 2014
Last updated in NPPESJune 7, 2026
Certification dateJune 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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