NPIMap

Individual provider Active NPI

Michael Kim Pheng, MD

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1386104719
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101274038 Issued in VA
Practice address
5460 Wesleyan Dr
Virginia Beach, VA 23455-6906
Phone
(757) 395-1900
NPI assigned
Mar 21, 2019
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 101274038 VA Primary

Addresses

Primary practice location

5460 Wesleyan Dr
Virginia Beach, VA 23455-6906

Mailing address

5460 Wesleyan Dr
Virginia Beach, VA 23455-6906

Other names 1

  • Michael K Pheng Other name

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
I20220608000365 VA Practitioner - Family Practice 1254668924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

5460 Wesleyan Dr
Virginia Beach, VA 23455-6906
Phone (757) 252-3050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101274038VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Family Medicine CurrentSince Jul 18, 2022 Accepting new patients

Locations

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

5460 Wesleyan Dr
Virginia Beach, VA 23455
Phone (757) 252-3050

Interoperability endpoints

  • Direct secure messaging: mpheng304971@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1386104719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 WESLEYAN DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 WESLEYAN DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556906",
            "telephone_number": "757-395-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHENG",
        "first_name": "MICHAEL",
        "middle_name": "KIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "101274038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "PHENG",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.