Jezeriah Wayne Cook, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002140 Issued in VA

Practice address

9 Manhattan SQ Ste a
Hampton, VA 23666-6262

Phone

(757) 838-6335

Fax

(757) 838-0612

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment Care Compare group NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Hospital Inc

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation
• Riverside Middle Peninsula Hospital Inc

  • General Acute Care Hospital
  • Gloucester, VA
  • NPI 1528162534
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1225066517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MANHATTAN SQ STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666262",
            "telephone_number": "757-838-6335",
            "fax_number": "757-838-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MANHATTAN SQ STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666262",
            "telephone_number": "757-838-6335",
            "fax_number": "757-838-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JEZERIAH",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hjalmar Contreras, DPM
• Convenient Healthcare VA, LLC
• Alva Cooper Cook, M.ED., CCC/SLP
• Heather Michelle Cook, DNP, APRN, FNP-BC
• Jamie Lynn Cook, PHARMD
• Jordyn M Cook
• Laura A Cook, LPC
• Tammy Cook
• Thomas Garrett Cook, IDMT
• Cathy G Cooke, PSY.D

• Physician Assistant in Hampton, VA
• Providers in Hampton, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.