Organization Active NPI

Riverside Physician Services Inc

  • Surgery Physician
  • Newport News, VA
National Provider Identifier
1407877178
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Practice address
109 Philip Roth St
Newport News, VA 23606-1393
Phone
(757) 873-6434
Fax
(757) 873-1882
NPI assigned
Jul 21, 2006
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
James Lesnick, MD
Title
Vice President
Phone
(757) 594-4006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X

Addresses

Primary practice location

109 Philip Roth St
Newport News, VA 23606-1393

Mailing address

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

Other names 1

  • Riverside Surgical Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040207000400 VA Part B Supplier - Clinic/Group Practice 5092608448 Receives reassigned benefits from 1,191 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2074100Riverside Hampton Roads Surgical Specialists-NN109 Philip Roth Street, Newport News, VA 23606Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory
Part of
RPS Ta Rvrsde Tpphnck GRP

Locations

8 Ivy Farms Rd
Newport News, VA 23601
Phone (757) 595-5534

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1407877178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-594-4006",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PHILIP ROTH ST",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061393",
            "telephone_number": "757-873-6434",
            "fax_number": "757-873-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOCIATES INC",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "LESNICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "757-594-4006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.