Individual provider Active NPI

Regan M Brecke, PA

  • Medical Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1497997191
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110840821 Issued in VA
Practice address
4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225
Phone
(757) 467-4200
Fax
(757) 686-0541
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110840821 VA Primary

Addresses

Primary practice location

4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225

Mailing address

4868 Bridge Rd
Suffolk, VA 23435-2048
Phone (757) 483-7100

Other names 1

  • Regan E Moore Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000661 VA Practitioner - Physician Assistant 2567519978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

1024 S Battlefield Blvd
Chesapeake, VA 23322-4215
Phone (757) 410-4488

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

2088 S Independence Blvd
Suite 103
Virginia Beach, VA 23453-4790
Phone (757) 275-9331

3060 Godwin Blvd
Suffolk, VA 23434-8274
Phone (757) 923-9660

4868 Bridge Rd
Suffolk, VA 23435-2048
Phone (757) 483-7113

6632 Indian River Rd
Suite 103
Virginia Beach, VA 23464-3442
Phone (757) 424-4442

Hospital & facility affiliations

  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jan 1, 2022 Accepting new patients
Bayview Physician Services, PC CurrentSince Jan 1, 2022 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients

Locations

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

4868 Bridge Rd
Ste 310
Suffolk, VA 23435
Phone (757) 483-7100

4868 Bridge Rd
Suffolk, VA 23435
Phone (757) 483-7113

3060 Godwin Blvd
Suffolk, VA 23434
Phone (757) 923-9660

Interoperability endpoints

  • Direct secure messaging: regan.brecke@bayview.eclinicaldirectplus.com

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1497997191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4868 BRIDGE RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352048",
            "telephone_number": "757-483-7100",
            "fax_number": "757-483-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 FOXWOOD DR",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625225",
            "telephone_number": "757-467-4200",
            "fax_number": "757-686-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKE",
        "first_name": "REGAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGAN",
            "last_name": "MOORE",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.