Individual provider Active NPI

John Hermansen, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Richmond, VA
National Provider Identifier
1568993699
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101274443 Issued in VA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone
(904) 210-9466
NPI assigned
Mar 21, 2017
Last updated
Oct 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 86645 GA
Physical Medicine & Rehabilitation Physician 208100000X 0101274443 VA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Mailing address

211 Dundee Ave
Richmond, VA 23225-4805

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
I20230112002930 VA Practitioner - General Surgery 2769752823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

2000 Wilkes Ridge PL
Richmond, VA 23233-7336
Phone (804) 342-4349

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86645GAMDPhysical Medicine & Rehabilitation Physician
0101274443VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Aug 13, 2022 Accepting new patients
Brian Dena DO LLC Physical Medicine & Rehabilitation CurrentSince Mar 12, 2024 Accepting new patients

Locations

95 Medical Park Blvd
Petersburg, VA 23805
Phone (336) 816-2589

2000 Wilkes Ridge Pl
Richmond, VA 23233
Phone (804) 342-4349

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Organizations & group practices 2

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 3

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1568993699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 DUNDEE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "904-210-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANSEN",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "86645",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101274443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.