Individual provider Active NPI

Benjamin Wells De Witt, M.D.

  • Emergency Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1649568361
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101265514 Issued in VA
Practice address
6632 Indian River Rd
Virginia Beach, VA 23464-3442
Phone
(757) 424-4300
Fax
(757) 523-0632
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101265514 VA Primary

Addresses

Primary practice location

6632 Indian River Rd
Virginia Beach, VA 23464-3442

Mailing address

PO Box 7068
Portsmouth, VA 23707-0068
Phone (757) 686-3508

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
I20190228000953 VA Practitioner - Emergency Medicine 6507188521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

4868 Bridge Rd
Suffolk, VA 23435-2048
Phone (757) 483-7113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Medical Center, Inc PastSince Dec 1, 2024 Accepting new patients
Nowcare Physicians Emergency Medicine PastSince Dec 1, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1649568361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6632 INDIAN RIVER RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643442",
            "telephone_number": "757-424-4300",
            "fax_number": "757-523-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE WITT",
        "first_name": "BENJAMIN",
        "middle_name": "WELLS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101265514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.