Individual provider Active NPI

Patricia L Marcuson, M.D.

  • Internal Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1609841485
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101048943 Issued in VA
Practice address
400 Sentara Cir
Suite 400
Williamsburg, VA 23188-5716
Phone
(757) 645-3150
Fax
(757) 645-3149
NPI assigned
Feb 23, 2006
Last updated
Oct 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 0101048943 VA Primary

Addresses

Primary practice location

400 Sentara Cir
Suite 400
Williamsburg, VA 23188-5716

Mailing address

860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 7

IdentifierTypeStateIssuer
541634477076OtherVATRICARE
P00323504OtherRR/MEDICARE
196181OtherVAANTHEM
28683OtherVASENTARA/OPTIMA
8154300/3154300OtherVAUNITED HEALTHCARE
010278341MedicaidVA
2820774001OtherVACIGNA HEALTHCARE

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
I20060721000066 VA Practitioner - Internal Medicine 5991609075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

132 Professional Cir
Williamsburg, VA 23185-3374
Phone (757) 232-8764

400 Sentara Cir
Suite 400
Williamsburg, VA 23188-5716
Phone (757) 645-3150

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101048943VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jul 1, 2006 Accepting new patients
Tidewater Physicians Multispecialty Group PC Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients

Locations

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

132 Professional Cir
Williamsburg, VA 23185
Phone (757) 232-8764

400 Sentara Cir
Ste 400
Williamsburg, VA 23188
Phone (757) 645-3150

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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 9

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1609841485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR",
            "address_2": "SUITE 400",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-645-3150",
            "fax_number": "757-645-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUSON",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101048943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "541634477076",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "P00323504",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "196181",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "28683",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "8154300/3154300",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010278341",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "2820774001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.