Individual provider Active NPI

Roger E. Schultz, M.D.

  • Urology Physician
  • Virginia Beach, VA
National Provider Identifier
1417935552
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101037972 Issued in VA
Practice address
225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone
(757) 457-5100
Fax
(757) 961-3696
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101037972 VA Primary

Addresses

Primary practice location

225 Clearfield Ave
Virginia Beach, VA 23462-1815

Mailing address

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100

Other practice location 1

120 Kings Way
Suite 3200
Williamsburg, VA 23185-2505
Phone (757) 253-0051

Other identifiers 1

IdentifierTypeStateIssuer
1417935552MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101037972VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Virginia, PC Urology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417935552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Kings Way",
            "address_2": "Suite 3200",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231852505",
            "country_code": "US",
            "telephone_number": "757-253-0051",
            "fax_number": "757-229-9526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "ROGER",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101037972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417935552",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.