Individual provider Active NPI

Bruce Mayer, MD

  • Family Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1104806173
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101046065 Issued in VA
Practice address
7151 Richmond Rd Ste 403
Williamsburg, VA 23188-7234
Phone
(757) 566-2045
Fax
(757) 741-2735
NPI assigned
Jan 18, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101046065 VA Primary

Addresses

Primary practice location

7151 Richmond Rd Ste 403
Williamsburg, VA 23188-7234

Mailing address

7151 Richmond Rd Ste 403
Williamsburg, VA 23188-7234
Phone (757) 566-2045

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
I20051025000301 VA Practitioner - Family Practice 2961429410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York Downstate Medical Center, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bruce Mayer MD PCGroup PAC ID 5193728756, 2 clinicians

Practice addresses (Care Compare)

7151 Richmond Rd
Suite 403
Williamsburg, VA 23188-7234
Phone (757) 566-2045

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce Mayer, MD PC Family Medicine CurrentSince Jun 1, 2006 Accepting new patients
American Addiction Treatment Center, Inc PastSince Jan 8, 2020 Accepting new patients

Locations

4622 Rochambeau Dr
Williamsburg, VA 23188
Phone (757) 566-2045

7151 Richmond Rd
Ste 403
Williamsburg, VA 23188
Phone (757) 565-5440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1104806173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 RICHMOND RD STE 403",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231887234",
            "telephone_number": "757-566-2045",
            "fax_number": "757-741-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 RICHMOND RD STE 403",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231887234",
            "telephone_number": "757-566-2045",
            "fax_number": "757-741-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101046065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.