Individual provider Active NPI

Paul M Derber, M.D.

  • Internal Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1366446809
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101241807 Issued in VA
Practice address
1168 First Colonial Rd
Ste 201
Virginia Beach, VA 23454-2444
Phone
(757) 481-1113
Fax
(757) 496-3822
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10179 NV
Hospitalist Physician 208M00000X 101241807 VA
Internal Medicine Physician 207R00000X 0101241807 VA Primary

Addresses

Primary practice location

1168 First Colonial Rd
Ste 201
Virginia Beach, VA 23454-2444

Mailing address

PO Box 7068
Portsmouth, VA 23707-0068
Phone (757) 686-3508

Other identifiers 3

IdentifierTypeStateIssuer
002018782MedicaidNV
179167OtherVABCBS VA
689437OtherSOUTHERN HEALTH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000177 VA Practitioner - Internal Medicine 6901791904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

Hospital & facility affiliations

  • Westminster-Canterbury at Home, LLC Home health agency, Virginia Beach, VA, CCN 497682
  • Sentara Home Care Services-Virginia Beach Home health agency, Chesapeake, VA, CCN 497747
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10179NVMDInternal Medicine Physician
0101241807VAMDInternal Medicine Physician
101241807VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jul 15, 2011 Accepting new patients
Bayview Physician Services, PC Internal Medicine CurrentSince Jul 15, 2011 Accepting new patients
Physicians Medical Center Kaufman, LTD Past Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients
Virginia Hospitalists Inc Internal Medicine Past Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

1168 First Colonial Rd
Ste 201
Virginia Beach, VA 23454
Phone (757) 481-1113

1168 First Colonial Rd
Ste 101
Virginia Beach, VA 23454
Phone (757) 481-2515

1168 First Colonial Rd
Ste 200
Virginia Beach, VA 23454
Phone (757) 496-9020

Interoperability endpoints

  • Direct secure messaging: paul.derber@bayview.eclinicaldirectplus.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 and National Provider Directory roles.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1366446809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 FIRST COLONIAL RD",
            "address_2": "STE 201",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542444",
            "telephone_number": "757-481-1113",
            "fax_number": "757-496-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBER",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10179",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "101241807",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101241807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018782",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS VA",
            "identifier": "179167",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "689437",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.