Individual provider Active NPI

Gary Jay Waxman, M.D.

  • Anesthesiology Physician
  • Virginia Beach, VA
National Provider Identifier
1023008018
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101059225 Issued in VA
Practice address
816 Independence Blvd
Ste 2a
Virginia Beach, VA 23455-6010
Phone
(757) 363-6712
Fax
(757) 363-6204
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101059225 VA Primary

Addresses

Primary practice location

816 Independence Blvd
Ste 2a
Virginia Beach, VA 23455-6010

Mailing address

816 Independence Blvd
Ste 2a
Virginia Beach, VA 23455-6010
Phone (757) 363-6712

Other identifiers 1

IdentifierTypeStateIssuer
010125529MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101059225VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suffolk Anesthesia Associates Anesthesiology Past Accepting new patients
Portsmouth Anesthesia Associates, P.C. Anesthesiology Past Accepting new patients
Anesthesia Healthcare Partners, Inc. Anesthesiology Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1023008018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 INDEPENDENCE BLVD",
            "address_2": "STE 2A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556010",
            "telephone_number": "757-363-6712",
            "fax_number": "757-363-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 INDEPENDENCE BLVD",
            "address_2": "STE 2A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556010",
            "telephone_number": "757-363-6712",
            "fax_number": "757-363-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "GARY",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101059225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010125529",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.