Individual provider Active NPI

Mark Phillip Moniz, MD

  • Surgery Physician
  • Williamsburg, VA
National Provider Identifier
1528067014
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101058407 Issued in VA
Practice address
120 Kings Way Ste 2600
Williamsburg, VA 23185-2554
Phone
(757) 345-0141
Fax
(757) 206-1291
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101058407 VA Primary

Addresses

Primary practice location

120 Kings Way Ste 2600
Williamsburg, VA 23185-2554

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

500 Sentara Cir
Suite 202
Williamsburg, VA 23188-5727
Phone (757) 984-9850

Other identifiers 1

IdentifierTypeStateIssuer
007311885MedicaidVA

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
I20070418000452 VA Practitioner - General Surgery 1658476759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at Houston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

120 Kings Way
Suite 2800
Williamsburg, VA 23185-2506
Phone (757) 534-9988

Hospital & facility affiliations

  • Riverside Home Health Home health agency, Newport News, VA, CCN 497467
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058407VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services, Inc. Surgery CurrentSince Jan 10, 2022 Accepting new patients
Urgent Specialty Associates PLLC Surgery CurrentSince Jul 5, 2018 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Jan 10, 2022 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

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

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

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

7101 Jahnke Rd
#260
Richmond, VA 23225
Phone (804) 716-7758

7101 Jahnke Rd
Ste 260
Richmond, VA 23225
Phone (804) 716-7755

3700 Battery Blvd
Ste 302
Williamsburg, VA 23185
Phone (757) 229-7939

120 Kings Way
Ste 2600
Williamsburg, VA 23185
Phone (757) 220-6823

120 Kings Way
Ste 2800
Williamsburg, VA 23185
Phone (757) 253-0777

Interoperability endpoints

  • Direct secure messaging: mmoniz63900@direct.rivhs.com

Organizations & group practices 5

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 4

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1528067014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY STE 2600",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852554",
            "telephone_number": "757-345-0141",
            "fax_number": "757-206-1291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Sentara Cir",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885727",
            "country_code": "US",
            "telephone_number": "757-984-9850",
            "fax_number": "757-345-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "MARK",
        "middle_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101058407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007311885",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.