Individual provider Active NPI

Jon D Mason, MD

  • Emergency Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1508898776
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101052125 Issued in VA
Practice address
4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225
Phone
(757) 467-4200
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101052125 VA Primary

Addresses

Primary practice location

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

Mailing address

PO Box 7549
Portsmouth, VA 23707-0549
Phone (757) 686-3508

Other identifiers 1

IdentifierTypeStateIssuer
5813671MedicaidVA

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
I20100929001227 VA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3779486170 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC CurrentSince Dec 1, 2001 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Aug 1, 2016 Accepting new patients
Emergency Physicians of Tidewater Emergency Medicine Past Accepting new patients

Locations

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1508898776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070549",
            "telephone_number": "757-686-3508"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "JON",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101052125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5813671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.