Individual provider Active NPI

Dennis Agyemang Boateng, PA-C

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1689035438
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005194 Issued in VA
Practice address
12997 Warwick Blvd
Newport News, VA 23602-8352
Phone
(757) 369-3357
Fax
(757) 369-3587
NPI assigned
Mar 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110005194 VA Primary

Addresses

Primary practice location

12997 Warwick Blvd
Newport News, VA 23602-8352

Mailing address

4134 Marjon CT
Dumfries, VA 22025-1991

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105001648 VA Practitioner - Physician Assistant 9032490016 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.74 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
77.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2023 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2023 Accepting new patients
CMH Physician Services, LLC CurrentSince Nov 18, 2018 Accepting new patients

Locations

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273

Organizations & group practices 10

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1689035438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 MARJON CT",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12997 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028352",
            "telephone_number": "757-369-3357",
            "fax_number": "757-369-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATENG",
        "first_name": "DENNIS",
        "middle_name": "AGYEMANG",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.