Individual provider Active NPI

Alison Criss Ibanez

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1265580401
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167759 Issued in VA
Practice address
4439 Virginia Beach Blvd
Virginia Beach, VA 23462-3100
Phone
(757) 252-0590
Fax
(757) 425-7180
NPI assigned
Jan 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001179524 VA
Family Nurse Practitioner 363LF0000X 0024167759 VA Primary

Addresses

Primary practice location

4439 Virginia Beach Blvd
Virginia Beach, VA 23462-3100

Mailing address

4439 Virginia Beach Blvd
Virginia Beach, VA 23462-3100
Phone (757) 252-0590

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080911000591 VA Practitioner - Nurse Practitioner 8729154976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

4439 Virginia Beach Blvd
Virginia Beach, VA 23462-3100
Phone (757) 252-0590

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001179524VAMDRegistered Nurse
0024167759VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Velocity Urgent Care, LLC CurrentSince Dec 1, 2017 Accepting new patients

Locations

3745 Holland Rd
Virginia Beach, VA 23452
Phone (757) 395-1700

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

Interoperability endpoints

  • Direct secure messaging: aibanez3137@direct.sentara.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1265580401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4439 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623100",
            "telephone_number": "757-252-0590",
            "fax_number": "757-425-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4439 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623100",
            "telephone_number": "757-252-0590",
            "fax_number": "757-425-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "ALISON",
        "middle_name": "CRISS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001179524",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.