Individual provider Active NPI

Kyle Allen Spanik, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1346701778
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006750 Issued in VA
Practice address
600 Gresham Dr Ste 204
Norfolk, VA 23507-1904
Phone
(757) 388-5680
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 0110006750 VA Primary

Addresses

Primary practice location

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904
Phone (757) 388-5680

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
I20191009001824 VA Practitioner - Physician Assistant 0840521662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2019
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)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-2323

1080 1St Colonial Rd
Virginia Beach, VA 23454-2406

600 Gresham Dr
Norfolk, VA 23507-1904

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

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Aug 14, 2019 Accepting new patients

Locations

600 Gresham Dr
Ste 204
Norfolk, VA 23507
Phone (757) 388-5680

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

Interoperability endpoints

  • Direct secure messaging: kspanik51223@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 6

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1346701778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANIK",
        "first_name": "KYLE",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.