Individual provider Active NPI

Michael T Miesner, PH.D.

  • Clinical Psychologist
  • North Chesterfield, VA
National Provider Identifier
1699082065
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081005215 Issued in VA
Practice address
1000 Boulers Parkway Ste 102
North Chesterfield, VA 23225
Phone
(804) 591-3134
NPI assigned
Sep 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 081005215 VA Primary

Addresses

Primary practice location

1000 Boulers Parkway Ste 102
North Chesterfield, VA 23225

Mailing address

1000 Boulders Pkwy
Ste 102
North Chesterfield, VA 23225-5515
Phone (804) 591-3134

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161006000018 VA Practitioner - Clinical Psychologist 7719272046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
East Tennessee State University Quillen College of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Pulmonary Associates of Richmond IncGroup PAC ID 8123095577, 49 clinicians
Behavioral Health Partners PCGroup PAC ID 2365767217, 5 clinicians

Practice addresses (Care Compare)

1000 Boulders Pkwy
Suite 101
North Chesterfield, VA 23225-5515
Phone (804) 320-4341

703 N Courthouse Rd
Suite 101
Richmond, VA 23236-4036
Phone (804) 794-4482

Merit-based Incentive Payment System (MIPS)

Final score
84.54 of 100Reported as group
Quality
71.96
Promoting interoperability
99
Improvement activities
40
Cost
77.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081005215VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates of Richmond Inc CurrentSince Jul 1, 2017 Accepting new patients
Dysphagia Management Systems, LLC PastSince Jan 19, 2023 Accepting new patients

Locations

2354 Colony Crossing Pl
Midlothian, VA 23112
Phone (804) 288-6261

1000 Boulders Pkwy
Ste 101
North Chesterfield, VA 23225
Phone (804) 320-4341

1000 Boulders Pkwy
Ste 102
North Chesterfield, VA 23225
Phone (804) 591-3134

2025 Waterside Rd
Prince George, VA 23875

6600 W Broad St
Ste 300
Richmond, VA 23230
Phone (804) 591-3134

1603 Santa Rosa Rd
Rm 201
Richmond, VA 23229
Phone (804) 282-1373

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1699082065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOULDERS PKWY",
            "address_2": "STE 102",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232255515",
            "telephone_number": "804-591-3134",
            "fax_number": "804-282-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BOULERS PARKWAY STE 102",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "23225",
            "telephone_number": "804-591-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIESNER",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081005215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.