Lucelly Mosquera

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Newport News, VA

NPI 1225849474 · NPPES record last updated Apr 7, 2026

Key facts

NPI
1225849474
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
0024195182 (VA)
Practice address
11828 Fishing Point Dr Ste 102
Newport News, VA 23606-4500
Phone
(757) 746-2332
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Tidewater Community Mental (22 clinicians)

Practice addresses (Care Compare)

1000 Commercial LN
Suffolk, VA 23434-8148
Phone (757) 966-2805

7025 Harbour View Blvd
Suite 119
Suffolk, VA 23435-2762
Phone (757) 966-2805

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260507001321 VA Practitioner - Nurse Practitioner 3870061807 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0024195182VAMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X 0024195182 VA Yes

Addresses

Primary practice location

11828 Fishing Point Dr Ste 102
Newport News, VA 23606-4500

Mailing address

7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762
Phone (757) 966-2805

Other providers in Newport News, VA

All providers in Newport News, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.