Individual provider Active NPI

Tommy Sun, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1124037221
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101032911 Issued in VA
Practice address
3396 Holland Rd
#105
Virginia Beach, VA 23452-4824
Phone
(757) 427-9194
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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 0101032911 VA Primary

Addresses

Primary practice location

3396 Holland Rd
#105
Virginia Beach, VA 23452-4824

Mailing address

3396 Holland Rd
#105
Virginia Beach, VA 23452-4824
Phone (757) 427-9194

Other identifiers 1

IdentifierTypeStateIssuer
5616697MedicaidVA

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
I20090216000381 VA Practitioner - Family Practice 3375608904 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101032911VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Family Medicine CurrentSince May 14, 2009 Accepting new patients
Green Run Family Practice, Inc Family Medicine PastSince Sep 1, 1996 Accepting new patients

Locations

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

1950 Glenn Mitchell Dr
Ste 300
Virginia Beach, VA 23456
Phone (757) 507-0305

Interoperability endpoints

  • Direct secure messaging: tsun2800@direct.sentara.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1124037221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 HOLLAND RD",
            "address_2": "#105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524824",
            "telephone_number": "757-427-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3396 HOLLAND RD",
            "address_2": "#105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524824",
            "telephone_number": "757-427-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "TOMMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5616697",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.