NPIMap

Individual provider Active NPI

Mitchell L Shiffman, MD

  • Gastroenterology Physician
  • Newport News, VA
National Provider Identifier
1497847461
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101036976 Issued in VA
Practice address
12720 McManus Blvd
Suite 313
Newport News, VA 23602-4414
Phone
(757) 947-3190
Fax
(757) 947-3195
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101036976 VA Primary

Addresses

Primary practice location

12720 McManus Blvd
Suite 313
Newport News, VA 23602-4414

Mailing address

12720 McManus Blvd
Suite 313
Newport News, VA 23602-4414
Phone (757) 947-3190

Other identifiers 2

IdentifierTypeStateIssuer
006000924MedicaidVA
C06778OtherVAMEDICARE GROUP PIN

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
I20091130000540 VA Practitioner - Gastroenterology 2163561416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Bon Secours-Richmond Community Hospital LLCGroup PAC ID 3274425459, 40 clinicians

Practice addresses (Care Compare)

5855 Bremo Rd
Suite 509
Richmond, VA 23226-1925
Phone (804) 977-8920

Hospital & facility affiliations

  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101036976VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours-Richmond Community Hospital LLC CurrentSince Nov 19, 2016 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Nov 17, 2024 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Nov 17, 2024 Accepting new patients
Maryview Hospital LLC Gastroenterology CurrentSince Aug 15, 2017 Accepting new patients
Maryview Hospital LLC CurrentSince Aug 15, 2017 Accepting new patients
Bon Secours-Richmond Community Hospital LLC Current Accepting new patients
Bon Secours-Richmond Community Hospital LLC CurrentSince Nov 19, 2016 Accepting new patients

Locations

12720 McManus Blvd
Ste 313
Newport News, VA 23602
Phone (757) 947-3190

155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5875 Bremo Rd
Ste 712
Richmond, VA 23226
Phone (804) 285-9416

5855 Bremo Rd
Ste 509
Richmond, VA 23226
Phone (804) 288-6261

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

5875 Bremo Rd
Ste G7
Richmond, VA 23226
Phone (804) 288-8900

Interoperability endpoints

  • Direct secure messaging: mshiffman1155686@direct.bsmhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1497847461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12720 MCMANUS BLVD",
            "address_2": "SUITE 313",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024414",
            "telephone_number": "757-947-3190",
            "fax_number": "757-947-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 MCMANUS BLVD",
            "address_2": "SUITE 313",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024414",
            "telephone_number": "757-947-3190",
            "fax_number": "757-947-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFMAN",
        "first_name": "MITCHELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101036976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006000924",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.