Individual provider Active NPI

Stephen W. Kayota, MD

  • Physical Medicine & Rehabilitation Physician
  • Virginia Beach, VA
National Provider Identifier
1083687099
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101053621 Issued in VA
Practice address
1120 First Colonial Rd
Suite 206
Virginia Beach, VA 23454-2418
Phone
(757) 496-2325
Fax
(757) 496-1942
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101053621 VA Primary

Addresses

Primary practice location

1120 First Colonial Rd
Suite 206
Virginia Beach, VA 23454-2418

Mailing address

1120 First Colonial Rd
Suite 206
Virginia Beach, VA 23454-2418
Phone (757) 496-2325

Other identifiers 11

IdentifierTypeStateIssuer
1083687099OtherVAAETNA
006802079MedicaidVA
1083687099OtherVAVIRGINIA HEALTH NETWORK
1083687099OtherVAHUMANA MEDICARE
1083687099OtherVAUNITED HEALTHCARE
1083687099OtherVAANTHEM BCBS VA
1083687099OtherVACOVENTRY
1083687099OtherVATRICARE
1083687099OtherVAOPTIMA
1083687099OtherVACIGNA
1083687099OtherVADEPARTMENT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000477 VA Practitioner - Physical Medicine and Rehabilitation 7113056375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1120 1St Colonial Rd
Suite 206
Virginia Beach, VA 23454-2418
Phone (757) 496-2325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053621VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gerry Nieman Smith MD LLC CurrentSince Oct 23, 2022 Accepting new patients
Integrated Medical Services PLC Past Accepting new patients

Locations

1120 First Colonial Rd
Ste 206
Virginia Beach, VA 23454
Phone (757) 496-2325

Interoperability endpoints

  • Direct secure messaging: stephenkayota@direct.meditouchehr.com

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1083687099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 206",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-496-2325",
            "fax_number": "757-496-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 206",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-496-2325",
            "fax_number": "757-496-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYOTA",
        "first_name": "STEPHEN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-10-19",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101053621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006802079",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS VA",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1083687099",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "1083687099",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.