Active NPI
Rose Elisabeth Benson
- Physician Assistant
- Norfolk, VA
National Provider Identifier
1104636620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110011141
- Practice address
- 825 Fairfax Ave
Norfolk, VA 23507-1914 - Phone
- (757) 446-5600
- NPI assigned
- Jan 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110011141 | VA | Primary |
Addresses
Primary practice location
825 Fairfax Ave
Norfolk, VA 23507-1914
Mailing address
825 Fairfax Ave
Norfolk, VA 23507-1914
Phone (757) 446-5600
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260306002745 | VA | Practitioner - Physician Assistant | 2163904269 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Eastern Virginia Medical School, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
457 Laurence Dr
Suite 444
Heath, TX 75032-2092
PO Box
Boston, MA 02284
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110011141 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians of Tidewater | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1104636620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071914",
"telephone_number": "757-446-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071914",
"telephone_number": "757-446-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "ROSE",
"middle_name": "ELISABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-08",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110011141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.