Active NPI
Miranda Chakos
- Psychiatry Physician
- Suffolk, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101053901
- Practice address
- 5131 River Club Dr Ste 200
Suffolk, VA 23435-3837 - Phone
- (804) 207-6737
- NPI assigned
- Mar 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101053901 | VA | Primary |
Addresses
Primary practice location
5131 River Club Dr Ste 200
Suffolk, VA 23435-3837
Mailing address
104 Knight St
Oceanside, NY 11572-4611
Phone (718) 270-1748
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20H872 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5131 River Club Dr
Suite 200
Suffolk, VA 23435-3837
Phone (804) 207-6737
9202 Ctr Oak CT
Mechanicsville, VA 23116-2744
Phone (804) 207-6737
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101053901 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Counseling Associates Inc | Psychiatry | Current | Accepting new patients |
| University Physicians of Brooklyn | Psychiatry | Past | Accepting new patients |
| Downstate Mental Hygiene Associates | Past | Accepting new patients |
Locations
9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112
5131 River Club Dr
Ste 200
Suffolk, VA 23435
Phone (757) 792-9756
Interoperability endpoints
- lifestancehealth.mirandachakos@134000.advancedmd-direct.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.
-
- Clinical Psychologist
- Mechanicsville, VA
- NPI 1851345805
Psychiatry
-
- Public Health or Welfare Agency
- Brooklyn, NY
- NPI 1386678373
-
- Psychiatry Physician
- Brooklyn, NY
- NPI 1558318006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1093775744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 KNIGHT ST",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115724611",
"telephone_number": "718-270-1748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5131 RIVER CLUB DR STE 200",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234353837",
"telephone_number": "804-207-6737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKOS",
"first_name": "MIRANDA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-26",
"last_updated": "2025-03-19",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101053901",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20H872",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.