Individual provider Active NPI

Robert Joseph Ackerman, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Newport News, VA
National Provider Identifier
1386613685
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
0101247192 Issued in VA
Practice address
439 Oriana Road Suite C
Riverside Pace
Newport News, VA 23602
Phone
(757) 234-8100
Fax
(757) 969-6835
NPI assigned
Mar 17, 2006
Last updated
Feb 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 0101247192 VA Primary

Addresses

Primary practice location

439 Oriana Road Suite C
Riverside Pace
Newport News, VA 23602

Mailing address

856 J Clyde Morris Blvd Suite a
Riverside Medical Group
Newport News, VA 23601-1318
Phone (757) 594-4006

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
I20160211002599 VA Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 5496889792

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101247192VAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Washington Geriatric Medicine Current Accepting new patients
Washington Hospital Past Accepting new patients

Locations

95 Leonard Ave
Washington, PA 15301
Phone (724) 223-3100

95 Leonard Ave
Bldg 2
Washington, PA 15301
Phone (724) 223-3100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1386613685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD SUITE A",
            "address_2": "RIVERSIDE MEDICAL GROUP",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-594-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 ORIANA ROAD SUITE C",
            "address_2": "RIVERSIDE PACE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23602",
            "telephone_number": "757-234-8100",
            "fax_number": "757-969-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101247192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.