NPIMap

Individual provider Active NPI

Robert Charles Menezes Jr., MD

  • Internal Medicine Physician
  • Hillsville, VA
National Provider Identifier
1356338016
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
199266 Issued in NY
Practice address
702 Pine St
Hillsville, VA 24343-1405
Phone
(276) 728-4311
Fax
(276) 728-0901
NPI assigned
Sep 28, 2005
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 199266 NY Primary

Addresses

Primary practice location

702 Pine St
Hillsville, VA 24343-1405

Mailing address

702 Pine St
Hillsville, VA 24343-1405
Phone (276) 728-4311

Other identifiers 1

IdentifierTypeStateIssuer
01585771MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202002591 VA Practitioner - Internal Medicine 7911046834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

104 Cranberry Rd
Galax, VA 24333-0009
Phone (276) 236-5187

702 Pine St
Hillsville, VA 24343-1405
Phone (276) 728-4311

961 E Stuart Dr
Galax, VA 24333-2407
Phone (276) 238-0439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
199266NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Twin County Physician Practices LLC CurrentSince Jan 4, 2016 Accepting new patients
DLP Twin County Physician Practices LLC CurrentSince Jan 4, 2016 Accepting new patients
DLP Twin County Physician Practices LLC Current Accepting new patients
DLP Twin County Physician Practices LLC Internal Medicine Past Accepting new patients
Crystal Run Healthcare Physicians LLP PastSince Feb 1, 1997 Accepting new patients

Locations

961 E Stuart Dr
Galax, VA 24333
Phone (276) 236-3931

702 Pine St
Hillsville, VA 24343
Phone (276) 728-4311

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10112/brand/1/csg/21/fhir/r4
  • Direct secure messaging: robert.menezes.1@10112.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1356338016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 PINE ST",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431405",
            "telephone_number": "276-728-4311",
            "fax_number": "276-728-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 PINE ST",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431405",
            "telephone_number": "276-728-4311",
            "fax_number": "276-728-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEZES",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01585771",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsville, VA

Sources for this page

Verify at the official NPI Registry.