Active NPI
Robert Bernard Laibstain, MD
- Family Medicine Physician
- Chesapeake, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101027421
- Practice address
- 1016 Justis St
Chesapeake, VA 23325 - Phone
- (757) 420-8297
- Fax
- (757) 523-5639
- NPI assigned
- Aug 8, 2006
- Last updated
- Dec 12, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101027421 | VA | Primary |
Addresses
Primary practice location
1016 Justis St
Chesapeake, VA 23325
Mailing address
860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8769
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5664250 | Medicaid | VA | |
| 028829 | Other | ANTHEM | |
| 11017 | Other | SENTARA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Physicians Multispecialty Group PC | Current | Accepting new patients | |
| Tidewater Physicians Multispecialty Group PC | Family Medicine | Current | Accepting new patients |
Locations
1016 Justis St
Chesapeake, VA 23325
Phone (757) 420-8297
13347 Warwick Blvd
Newport News, VA 23602
Phone (757) 877-0214
729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077
827 Diligence Dr
Ste 100
Newport News, VA 23606
860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BGFHDD
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.
-
- Family Medicine Physician
- Newport News, VA
- NPI 1902848294
-
- Ambulatory Surgical Clinic/Center
- Williamsburg, VA
- NPI 1316790512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386806400000",
"number": "1396755948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 OMNI BLVD",
"address_2": "SUITE 303",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236064430",
"telephone_number": "757-232-8769",
"fax_number": "757-232-8875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 JUSTIS ST",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "23325",
"telephone_number": "757-420-8297",
"fax_number": "757-523-5639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAIBSTAIN",
"first_name": "ROBERT",
"middle_name": "BERNARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2013-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101027421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5664250",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "028829",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "11017",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.