Individual provider Active NPI

Michael Probert, PA-C

  • Physician Assistant
  • Williamsburg, VA
National Provider Identifier
1528509007
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C06422 Issued in MD
Practice address
120 Kings Way Ste 2800
Williamsburg, VA 23185-2506
Phone
(757) 534-9988
NPI assigned
Mar 16, 2017
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 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 0110009555 VA
Physician Assistant 363A00000X C06422 MD Primary

Addresses

Primary practice location

120 Kings Way Ste 2800
Williamsburg, VA 23185-2506

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200424001572 WA Practitioner - Physician Assistant 2163794652 Reassigns benefits to 1 organization
I20231128002889 VA Practitioner - Physician Assistant 2163794652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Pittsburgh School of Medicine, 2016
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)

12200 Warwick Blvd
Newport News, VA 23601-2344

1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250

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

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110009555VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Oct 30, 2023 Accepting new patients
Multicare Health System CurrentSince Apr 13, 2020 Accepting new patients
Riverside Physcian Services Inc CurrentSince Oct 30, 2023 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12200 Warwick Blvd
Ste 490
Newport News, VA 23601
Phone (757) 534-5600

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

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

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

3700 Battery Blvd
Ste 100
Williamsburg, VA 23185
Phone (757) 534-9988

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

3124 S 19th St
Ste 340
Tacoma, WA 98405
Phone (253) 459-7000

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

316 S K St
Tacoma, WA 98405
Phone (253) 403-1375

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

  • Direct secure messaging: mprobert220850@direct.rivhs.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1528509007",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY STE 2800",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852506",
            "telephone_number": "757-534-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBERT",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009555",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.