NPIMap

Individual provider Active NPI

Michael B Degrandpre, PA

  • Physician Assistant
  • Mechanicsville, VA
National Provider Identifier
1366486060
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001114 Issued in VA
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 764-6111
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15582 NC
Physician Assistant 363A00000X 0110001114 VA Primary

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

PO Box 3648
Williamsburg, VA 23187-3648
Phone (757) 221-7111

Other practice location 1

4800 S Croatan Hwy
Nags Head, NC 27959-9704
Phone (252) 449-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040708000545 VA Practitioner - Physician Assistant 2567440464 Reassigns benefits to 1 organization
I20260227003003 NC Practitioner - Physician Assistant 2567440464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outer Banks Professional Services, LLCGroup PAC ID 3173652096, 163 clinicians

Practice addresses (Care Compare)

4800 S Croatan Hwy
Nags Head, NC 27959-9704
Phone (252) 449-4500

Merit-based Incentive Payment System (MIPS)

Final score
81.91 of 100Reported as group
Quality
78.72
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006222NYMDMental Health Counselor
0010-15582NCMDPhysician Assistant
0110001114VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Feb 17, 2026 Accepting new patients
Williamsburg Emergency Physicians CurrentSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Em-I Medical Services, PC Past Accepting new patients
Riverside Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Riverside Physician Services, Inc. Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Emergency Physicians of Southern Virginia LLP Physician Assistant Past Accepting new patients

Locations

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

111 Bulifants Blvd
Ste B
Williamsburg, VA 23188
Phone (757) 221-0006

Organizations & group practices 12

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1366486060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3648",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231873648",
            "telephone_number": "757-221-7111",
            "fax_number": "757-221-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-764-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 S Croatan Hwy",
            "address_purpose": "LOCATION",
            "city": "Nags Head",
            "state": "NC",
            "postal_code": "279599704",
            "country_code": "US",
            "telephone_number": "252-449-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGRANDPRE",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15582",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.