NPIMap

Individual provider Active NPI

Justin R Mize, PA

  • Medical Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1104152479
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110003168 Issued in VA
Practice address
4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225
Phone
(757) 467-4200
Fax
(757) 686-0541
NPI assigned
Oct 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110003168 VA Primary

Addresses

Primary practice location

4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225

Mailing address

PO Box 7549
Portsmouth, VA 23707-0549
Phone (757) 686-3515

Other practice location 1

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100 ext. 3782

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
I20091202000369 VA Practitioner - Physician Assistant 3678612728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of Virginia, PLLCGroup PAC ID 2062681679, 74 clinicians

Practice addresses (Care Compare)

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 452-3599

229 Clearfield Ave
Suite 300
Virginia Beach, VA 23462-1815
Phone (757) 457-5177

596 Lynnhaven Pkwy
Suite 200
Virginia Beach, VA 23452-7371
Phone (757) 457-5100

7185 Harbour Towne Pkwy S
Suite 200
Suffolk, VA 23435-3796
Phone (757) 457-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.25 of 100Reported as group
Quality
57.23
Promoting interoperability
100
Improvement activities
40
Cost
73.62

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110003168VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Virginia, PLLC CurrentSince Nov 28, 2022 Accepting new patients
Urology of Virginia, PLLC CurrentSince Nov 28, 2022 Accepting new patients

Locations

225 Clearfield Ave
Virginia Beach, VA 23462
Phone (757) 452-3459

Interoperability endpoints

  • Direct secure messaging: jmize1445457@direct.bsmhealth.org

Organizations & group practices 2

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 8

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": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1104152479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070549",
            "telephone_number": "757-686-3515",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 FOXWOOD DR",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625225",
            "telephone_number": "757-467-4200",
            "fax_number": "757-686-0541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Clearfield Ave",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621815",
            "country_code": "US",
            "telephone_number": "757-457-5100 x3782",
            "fax_number": "757-961-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZE",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.