Individual provider Active NPI

Erin Icenbice, PA

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1124137120
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001733 Issued in VA
Practice address
736 Battlefield Blvd N
Chesapeake Regional Medical Center
Chesapeake, VA 23320-4941
Phone
(757) 312-6128
Fax
(757) 312-6181
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001733 VA Primary
Medical Physician Assistant 363AM0700X 0110001733 VA

Addresses

Primary practice location

736 Battlefield Blvd N
Chesapeake Regional Medical Center
Chesapeake, VA 23320-4941

Mailing address

109 Gainsborough SQ
Ste G PMB 723
Chesapeake, VA 23320-1707
Phone (757) 490-9388

Other identifiers 1

IdentifierTypeStateIssuer
P00135004OtherMEDICARE RAILROAD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000498 VA Practitioner - Physician Assistant 6901708577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Observation Medicine Specialists PCGroup PAC ID 3577045053, 19 clinicians

Practice addresses (Care Compare)

736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 490-9388

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as group
Quality
88.62
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Observation Medicine Specialists, P.C. CurrentSince Feb 1, 2026 Accepting new patients
Tidewater Emergency Medical Care Physician Assistant PastSince Feb 2, 2020 Accepting new patients
Open MRI of Fairview Past Accepting new patients

Locations

109 Gainsborough Sq
Ste G
Chesapeake, VA 23320
Phone (757) 490-9388

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1124137120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GAINSBOROUGH SQ",
            "address_2": "STE G PMB 723",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201707",
            "telephone_number": "757-490-9388",
            "fax_number": "757-301-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BATTLEFIELD BLVD N",
            "address_2": "CHESAPEAKE REGIONAL MEDICAL CENTER",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204941",
            "telephone_number": "757-312-6128",
            "fax_number": "757-312-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICENBICE",
        "first_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001733",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00135004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.