Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tedric D Lolis, PA-C

Individual provider Surgical Physician Assistant · NPI 1114660289

Tedric D Lolis, PA-C is a Physician Assistant in Charlottesville, Virginia. Qualified in 2021, 5 years ago. Practices with East Mountain Health Physicians Inc, a 91-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2022
Specialties on file
2
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

1215 Lee St
Charlottesville, VA 22908-0816
Phone: (434) 924-9400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1008 Tavern Rd Ste 102, Martinsburg, WV 25401-2801 — (304) 263-5129

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008916 (VA)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1114660289
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 18, 2022
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice East Mountain Health Physicians Inc — 91 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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