NPIMap

Organization Active NPI

Riverside Hospital Inc

Doing business as Riverside Brentwood Medical Center - Family Medicine

  • Family Medicine Physician
  • Newport News, VA
National Provider Identifier
1245256908
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVERSIDE HOSPITAL INC
Doing business as
Riverside Brentwood Medical Center - Family Medicine
Practice address
10510 Jefferson Ave
Suites a
Newport News, VA 23601-3102
Phone
(757) 594-3800
Fax
(757) 594-3818
NPI assigned
Jul 14, 2006
Last updated
Oct 15, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
James Lesnick
Title
Vice President
Phone
(757) 594-4006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

10510 Jefferson Ave
Suites a
Newport News, VA 23601-3102

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318
Phone (757) 594-4006

Other identifiers 1

IdentifierTypeStateIssuer
CG6038OtherVAMEDICARE RAILROAD

Other names 1

  • Riverside Brentwood Medical Center - Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517000888 VA Part B Supplier - Clinic/Group Practice 1557271293 Receives reassigned benefits from 84 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hampton, VA; Newport News, VA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1245256908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-594-4006",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE",
            "address_2": "SUITES A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102",
            "telephone_number": "757-594-3800",
            "fax_number": "757-594-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOCIATES",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "LESNICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "757-594-4006"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG6038",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Brentwood Medical Center - Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.