Individual provider Active NPI

Amira Elhassan, MD

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1104868728
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101263097 Issued in VA
Practice address
5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone
(757) 473-3969
Fax
(757) 506-0157
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 0101263097 VA Primary

Addresses

Primary practice location

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629

Mailing address

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone (757) 473-3969

Other identifiers 1

IdentifierTypeStateIssuer
268108100MedicaidFL

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
I20171128000385 VA Practitioner - Family Practice 9830085687 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101263097VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jencare Neighborhood Medical Center Virginia Beach LLC CurrentSince Jul 1, 2023 Accepting new patients
Bon Secours Medical Group Hampton Roads Primary Care LLC CurrentSince Jan 1, 2020 Accepting new patients
PMR Virginia Holding, LLC CurrentSince Jul 1, 2023 Accepting new patients
Jencare Neighborhood Medical East Richmond, LLC PastSince Sep 4, 2012 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

3537 Airline Blvd
Ste 1
Portsmouth, VA 23701
Phone (757) 738-1225

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

828 Healthy Way
Ste 220
Virginia Beach, VA 23462
Phone (757) 305-1797

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

4421 Virginia Beach Blvd
Ste 114
Virginia Beach, VA 23462
Phone (757) 738-1300

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1104868728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELHASSAN",
        "first_name": "AMIRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101263097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268108100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.