Individual provider Active NPI

Mark Ancel Guerrero Edang, M.D.

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1508064502
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101254627 Issued in VA
Practice address
600 Gresham Dr FL 5
Norfolk, VA 23507-1904
Phone
(757) 388-3198
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38947 IA
Hospitalist Physician 208M00000X 38947 IA
Hospitalist Physician 208M00000X 0101254627 VA
Internal Medicine Physician 207R00000X 0101254627 VA Primary

Addresses

Primary practice location

600 Gresham Dr FL 5
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr FL 5
Norfolk, VA 23507-1904
Phone (757) 388-3198

Other names 1

  • Mark Ancel G Edang Other 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131108000927 VA Practitioner - HospitalistPractitioner - Internal Medicine 7911023395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-3198

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38947IAMDInternal Medicine Physician
0101254627VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Apr 11, 2016 Accepting new patients
Apogee Medical Group Virginia, PC Internal Medicine CurrentSince Sep 1, 2013 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

600 Gresham Dr
#5B
Norfolk, VA 23507
Phone (757) 388-3198

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

600 Gresham Dr
Fl 5
Norfolk, VA 23507
Phone (757) 388-3198

600 Gresham Dr
Ste 5TH
Norfolk, VA 23507

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1508064502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR FL 5",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR FL 5",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDANG",
        "first_name": "MARK ANCEL",
        "middle_name": "GUERRERO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "38947",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "38947",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101254627",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101254627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK ANCEL",
            "last_name": "EDANG",
            "middle_name": "G",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.