Individual provider Active NPI

Amber Lynn Sourbeer, PA-C

  • Medical Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1336692524
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110005448 Issued in VA
Practice address
2075 Glenn Mitchell Dr
Ste 400
Virginia Beach, VA 23456-0179
Phone
(757) 507-8900
NPI assigned
Jul 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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 0110005448 VA Primary

Addresses

Primary practice location

2075 Glenn Mitchell Dr
Ste 400
Virginia Beach, VA 23456-0179

Mailing address

2075 Glenn Mitchell Dr
Ste 400
Virginia Beach, VA 23456-0179
Phone (757) 507-8900

Other names 1

  • Amber Lynn Achesinski Former name

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
I20161017000618 VA Practitioner - Physician Assistant 3870881337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

844 Kempsville Rd
Norfolk, VA 23502-3927

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110005448VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Aug 22, 2016 Accepting new patients

Locations

844 Kempsville Rd
Ste 204
Norfolk, VA 23502
Phone (757) 261-0700

844 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0700

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

2075 Glenn Mitchell Dr
Ste 400
Virginia Beach, VA 23456
Phone (757) 252-9365

Interoperability endpoints

  • Direct secure messaging: aachesinski160240@direct.sentara.net

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.

Hospital & facility affiliations 5

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1336692524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 GLENN MITCHELL DR",
            "address_2": "STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560179",
            "telephone_number": "757-507-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 GLENN MITCHELL DR",
            "address_2": "STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560179",
            "telephone_number": "757-507-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURBEER",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "ACHESINSKI",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.