Individual provider Active NPI

Tuyet Mai Dang Houston, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Hampton, VA
National Provider Identifier
1275717449
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
01100004043 Issued in VA
Practice address
77 Nealy Blvd
Hampton, VA 23665-2023
Phone
(757) 225-6727
Fax
(757) 764-6884
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 01100004043 VA Primary

Addresses

Primary practice location

77 Nealy Blvd
Hampton, VA 23665-2023

Mailing address

77 Nealy Blvd
Hampton, VA 23665-2023
Phone (757) 225-6727

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
I20130107000083 VA Practitioner - Physician Assistant 5597817411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Beach Urgent Care LLCGroup PAC ID 7719259571, 6 clinicians

Practice addresses (Care Compare)

9545 Shore Dr
Norfolk, VA 23518-1711
Phone (757) 785-4861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01100004043VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Beach Urgent Care LLC CurrentSince Aug 22, 2025 Accepting new patients

Locations

9545 Shore Dr
Norfolk, VA 23518
Phone (757) 785-4861

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.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1275717449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NEALY BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236652023",
            "telephone_number": "757-225-6727",
            "fax_number": "757-764-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236652023",
            "telephone_number": "757-225-6727",
            "fax_number": "757-764-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "TUYET MAI",
        "middle_name": "DANG",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "01100004043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.