NPIMap

Individual provider Active NPI

Shawke A Soueidan, MD

  • Neurology Physician
  • Williamsburg, VA
National Provider Identifier
1093787376
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101048000 Issued in VA
Practice address
120 Kings Way
Suite 2700
Williamsburg, VA 23185-2505
Phone
(757) 221-0110
Fax
(757) 221-0851
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101048000 VA Primary

Addresses

Primary practice location

120 Kings Way
Suite 2700
Williamsburg, VA 23185-2505

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318

Other identifiers 1

IdentifierTypeStateIssuer
1093787376MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070507000628 VA Practitioner - Neurology 8820194947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

120 Kings Way
Suite 2700
Williamsburg, VA 23185-2554
Phone (757) 221-0110

Hospital & facility affiliations

  • Riverside Home Health Home health agency, Newport News, VA, CCN 497467
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101048000VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. Neurology CurrentSince Aug 1, 2013 Accepting new patients
Riverside Physician Services Inc CurrentSince Aug 1, 2013 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

7547 Medical Dr
Ste 1300
Gloucester, VA 23061
Phone (804) 695-8550

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

120 Kings Way
Ste 2700
Williamsburg, VA 23185
Phone (757) 221-0110

Interoperability endpoints

  • Direct secure messaging: ssoueidan11855@direct.rivhs.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1093787376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 2700",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-221-0110",
            "fax_number": "757-221-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUEIDAN",
        "first_name": "SHAWKE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101048000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093787376",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.