Individual provider Active NPI

Michael Brian Stuck, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1538872247
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009402 Issued in VA
Practice address
301 Riverview Ave Ste 700
Norfolk, VA 23510-1065
Phone
(757) 252-9365
NPI assigned
Dec 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0110009402 VA Primary

Addresses

Primary practice location

301 Riverview Ave Ste 700
Norfolk, VA 23510-1065

Mailing address

301 Riverview Ave Ste 700
Norfolk, VA 23510-1065
Phone (757) 252-9365

Other practice location 1

825 Fairfax Ave
Norfolk, VA 23507-1914
Phone (757) 446-5600

Other names 1

  • Michael B Stuck 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016002520 VA Practitioner - Physician Assistant 1759736432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

2790 Godwin Blvd
Suffolk, VA 23434-8151

600 Gresham Dr
Norfolk, VA 23507-1904

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

844 Kempsville Rd
Norfolk, VA 23502-3927

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Sep 1, 2023 Accepting new patients

Locations

301 Riverview Ave
Ste 700
Norfolk, VA 23510
Phone (757) 252-9365

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

Organizations & group practices 1

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": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1538872247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 700",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-252-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 700",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-252-9365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071914",
            "country_code": "US",
            "telephone_number": "757-446-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCK",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "STUCK",
            "middle_name": "B",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.