Individual provider Active NPI

Augustine O Bosah, MD

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1588794192
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101244465 Issued in VA
Practice address
549 E Brambleton Ave
Norfolk, VA 23510-2905
Phone
(757) 393-1136
Fax
(757) 533-9441
NPI assigned
Mar 6, 2007
Last updated
May 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101244465 VA Primary

Addresses

Primary practice location

549 E Brambleton Ave
Norfolk, VA 23510-2905

Mailing address

549 E Brambleton Ave
Norfolk, VA 23510-2905
Phone (757) 393-1136

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
I20090330000344 VA Practitioner - Internal Medicine 1759448103 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101244465VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Jun 1, 2025 Accepting new patients
Jencare Neighborhood Medical East Richmond, LLC Internal Medicine PastSince Sep 4, 2012 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

549 E Brambleton Ave
Norfolk, VA 23510
Phone (757) 393-1136

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1588794192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 E BRAMBLETON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102905",
            "telephone_number": "757-393-1136",
            "fax_number": "757-533-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 E BRAMBLETON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102905",
            "telephone_number": "757-393-1136",
            "fax_number": "757-533-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAH",
        "first_name": "AUGUSTINE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101244465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.