Individual provider Active NPI

Kristina Rea Black Kratovil, M.D.

  • Obesity Medicine (Internal Medicine) Physician
  • Vienna, VA
National Provider Identifier
1093881567
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
0101240416 Issued in VA
Practice address
8300 Boone Blvd Ste 500
Vienna, VA 22182-2681
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Nov 28, 2006
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101240416 VA
Internal Medicine Physician 207R00000X 2025-01557 NC
Internal Medicine Physician 207R00000X 01081902A IN
Obesity Medicine (Internal Medicine) Physician 207RB0002X 0101240416 VA Primary

Addresses

Primary practice location

8300 Boone Blvd Ste 500
Vienna, VA 22182-2681

Mailing address

109 State St Ste 5
Boston, MA 02109-2906
Phone (617) 505-1520

Other names 1

  • Dr. Kristina Rea Black Former name

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
I20180813001138 VA Practitioner - Internal Medicine 8022236462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

3920 Bridge Rd
Suite 207
Suffolk, VA 23435-1118
Phone (757) 983-2210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Aug 3, 2018 Accepting new patients

Locations

6333 Center Dr
Bldg 16
Norfolk, VA 23502
Phone (757) 252-9500

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

3920 Bridge Rd
#A207
Suffolk, VA 23435
Phone (757) 252-3294

3920A Bridge Rd
Ste 207
Suffolk, VA 23435
Phone (757) 925-0759

Interoperability endpoints

  • Direct secure messaging: kkratovil57008@direct.sentara.net

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1093881567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BOONE BLVD STE 500",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822681",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATOVIL",
        "first_name": "KRISTINA",
        "middle_name": "REA BLACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240416",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2025-01557",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01081902A",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "VA",
            "license": "0101240416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "BLACK",
            "middle_name": "REA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.