Individual provider Active NPI

Dereje Zewde Haile, MD

  • Internal Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1619940228
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101058970 Issued in VA
Practice address
1060 First Colonial Rd FL 1
Virginia Beach, VA 23454-3002
Phone
(757) 395-2323
Fax
(757) 827-2255
NPI assigned
Feb 13, 2006
Last updated
May 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101058970 VA Primary
Hospitalist Physician 208M00000X 0101058970 VA

Addresses

Primary practice location

1060 First Colonial Rd FL 1
Virginia Beach, VA 23454-3002

Mailing address

1060 First Colonial Rd FL 1
Virginia Beach, VA 23454-3002
Phone (757) 395-2323

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
I20051019000072 VA Practitioner - Internal Medicine 1052336468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058970VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Nov 1, 2005 Accepting new patients
Matrix House Physicians PA Internal Medicine Past Accepting new patients

Locations

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

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

1060 First Colonial Rd
Fl 1
Virginia Beach, VA 23454
Phone (757) 395-2323

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 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1619940228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 FIRST COLONIAL RD FL 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543002",
            "telephone_number": "757-395-2323",
            "fax_number": "757-827-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 FIRST COLONIAL RD FL 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543002",
            "telephone_number": "757-395-2323",
            "fax_number": "757-827-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILE",
        "first_name": "DEREJE",
        "middle_name": "ZEWDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101058970",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101058970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.