Individual provider Active NPI

Amani Divine Jones

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1508552621
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009604 Issued in VA
Practice address
12200 Warwick Blvd Ste 290
Newport News, VA 23601-2344
Phone
(757) 534-5454
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 0110009604 VA Primary

Addresses

Primary practice location

12200 Warwick Blvd Ste 290
Newport News, VA 23601-2344

Mailing address

1008 Innis Dr
Fredericksburg, VA 22401-6624
Phone (910) 554-9334

Other practice location 1

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2000

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
I20231128000605 VA Practitioner - Physician Assistant 2567810872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michumi PLLCGroup PAC ID 5193784395, 40 clinicians
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

120 Monticello Ave
Williamsburg, VA 23185-2840
Phone (757) 564-3627

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

6567 George Washington Memorial Hwy
Gloucester, VA 23061-3754
Phone (804) 824-9962

856 J Clyde Morris Blvd
Newport News, VA 23601-1318

856 J Clyde Morris Blvd a
Newport News, VA 23601-1318

Hospital & facility affiliations

  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Oct 30, 2023 Accepting new patients
Riverside Physician Services Inc CurrentSince Oct 30, 2023 Accepting new patients
Peninsula Radiological Associates Limited Past Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

12200 Warwick Blvd
Ste 290
Newport News, VA 23601
Phone (757) 534-5454

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000

Organizations & group practices 6

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1508552621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 INNIS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016624",
            "telephone_number": "910-554-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WARWICK BLVD STE 290",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012344",
            "telephone_number": "757-534-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 J Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-594-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "AMANI",
        "middle_name": "DIVINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.