Individual provider Active NPI

Masoumeh Kiamanesh, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Virginia Beach, VA
National Provider Identifier
1225267651
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
0101251900 Issued in VA
Practice address
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone
(757) 507-4123
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101251900 VA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 70275 MN
Hospitalist Physician 208M00000X 0101251900 VA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 0101251900 VA Primary

Addresses

Primary practice location

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178

Mailing address

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-4123

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 2

1080 First Colonial Rd
Ste 400
Virginia Beach, VA 23454-2406
Phone (757) 395-8720

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkiamanesh1521762@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MN2 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
I20121120000402 VA Practitioner - HospitalistPractitioner - Geriatric MedicinePractitioner - Family Practice 4587815691 Reassigns benefits to 1 organization
I20211013003424 MN Practitioner - Hospice/Palliative Care 4587815691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101251900VAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Current Accepting new patients
Sentara Medical Group Family Medicine CurrentSince Nov 13, 2012 Accepting new patients
Mayo Clinic CurrentSince Sep 30, 2021 Accepting new patients
Mayo Clinic CurrentSince Sep 30, 2021 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

1080 First Colonial Rd
Ste 400
Virginia Beach, VA 23454
Phone (757) 395-1880

Interoperability endpoints

  • Direct secure messaging: mkiamanesh1521762@ehrdirect.mayoclinicmsg.org
  • Direct secure messaging: mkiamanesh23993@direct.sentara.net

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1225267651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GLENN MITCHELL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560178",
            "telephone_number": "757-507-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GLENN MITCHELL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560178",
            "telephone_number": "757-507-4123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1080 First Colonial Rd",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234542406",
            "country_code": "US",
            "telephone_number": "757-395-8720",
            "fax_number": "757-395-8821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIAMANESH",
        "first_name": "MASOUMEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101251900",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "70275",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101251900",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101251900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkiamanesh1521762@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.