Individual provider Active NPI

Gregory J. Biernacki, MD

  • Family Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1194789909
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101041954 Issued in VA
Practice address
4374 New Town Ave
Suite 200
Williamsburg, VA 23188-2865
Phone
(757) 220-2795
Fax
(757) 259-8797
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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 0101041954 VA Primary

Addresses

Primary practice location

4374 New Town Ave
Suite 200
Williamsburg, VA 23188-2865

Mailing address

4374 New Town Ave
Suite 200
Williamsburg, VA 23188-2865
Phone (757) 220-2795

Other identifiers 2

IdentifierTypeStateIssuer
010111480MedicaidVA
840000185OtherVARAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080102000442 VA Practitioner - Preventive Medicine 6507946639 Reassigns benefits to 1 organization
I20160129000375 NC Practitioner - Family Practice 6507946639 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Sep 4, 2018 Accepting new patients
Outer Banks Professional Services, LLC Family Medicine CurrentSince Sep 4, 2018 Accepting new patients
Velocity Urgent Care, LLC CurrentSince Dec 1, 2017 Accepting new patients
Albemarle Physician Services - Sentara, Inc Family Medicine CurrentSince Jan 4, 2016 Accepting new patients
Albemarle Physician Services - Sentara, Inc CurrentSince Jan 4, 2016 Accepting new patients
Riverside Physician Services, Inc. Past Accepting new patients

Locations

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

905 Thunder Rd
Ste 210
Elizabeth City, NC 27909
Phone (252) 334-0460

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124

4374 New Town Ave
Ste 200
Williamsburg, VA 23188
Phone (757) 220-2795

Interoperability endpoints

  • Direct secure messaging: greg.biernacki.1@17374.direct.athenahealth.com
  • Direct secure messaging: gregory.biernacki.24@17374.direct.athenahealth.com
  • Direct secure messaging: gregory.biernacki.16@17374.direct.athenahealth.com
  • Direct secure messaging: greg.biernacki.2@17374.direct.athenahealth.com
  • Direct secure messaging: gregory.biernacki.26@17374.direct.athenahealth.com
  • Direct secure messaging: gregory.biernacki.11@17374.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Olde Towne Medical and Dental CenterWilliamsburg, VA, CCN 493825 Rural health clinic Corporate Director May 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1194789909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE",
            "address_2": "SUITE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-220-2795",
            "fax_number": "757-259-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE",
            "address_2": "SUITE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-220-2795",
            "fax_number": "757-259-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIERNACKI",
        "first_name": "GREGORY",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101041954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010111480",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "840000185",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.