Individual provider Active NPI

Michael Tobeh Kometa, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Petersburg, VA
National Provider Identifier
1700042231
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
0101249428 Issued in VA
Practice address
200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone
(804) 765-5991
Fax
(804) 765-5244
NPI assigned
Aug 4, 2008
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2023-01286 NC
Adolescent Medicine (Internal Medicine) Physician 207RA0000X KOME3968700 OH
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 0101249428 VA Primary

Addresses

Primary practice location

200 Medical Park Blvd
Petersburg, VA 23805-9274

Mailing address

200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone (804) 765-5991

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5680

Other practice location 2

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000 ext. 56949

Other identifiers 1

IdentifierTypeStateIssuer
1700042231MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110607000107 VA Practitioner - Internal Medicine 2769669472 Reassigns benefits to 2 organizations
I20230614004173 NC Practitioner - Internal Medicine 2769669472 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of North Carolina PCGroup PAC ID 7911954714, 66 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

1144 N Rd St
Elizabeth City, NC 27909-3473
Phone (852) 335-0531

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-8000

2 Bernadine Dr
Newport News, VA 23602-4404
Phone (240) 686-2300

2000 Neuse Blvd
New Bern, NC 28560-3449
Phone (252) 633-8108

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (336) 538-7000

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 535-8240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.85 of 100Reported as group
Quality
74.19
Improvement activities
40
Cost
73.55

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

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KOME3968700OHMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Medical Group, PC CurrentSince Jan 1, 2025 Accepting new patients
CMH Physician Services, LLC Internal Medicine CurrentSince Apr 8, 2016 Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 8, 2023 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Mar 29, 2019 Accepting new patients
CMH Physician Services, LLC CurrentSince Apr 8, 2016 Accepting new patients
Usacs Integrated Acute Care Services of North Carolina, PLLC Internal Medicine CurrentSince May 17, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 8, 2023 Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Jul 18, 2023 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 1, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Mar 29, 2019 Accepting new patients
Arnot Medical Services PLLC Internal Medicine Past Accepting new patients

Locations

260 Hospital Dr
Brevard, NC 28712
Phone (828) 883-5286

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

124 One Center Ct
Franklin, NC 28734
Phone (828) 369-4214

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

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

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

2 Bernardine Dr
Newport News, VA 23602
Phone (757) 886-6000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

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

Organizations & group practices 12

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 5

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1700042231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5991",
            "fax_number": "804-765-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5991",
            "fax_number": "804-765-5244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-5680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Medical Pavilion Dr",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283769111",
            "country_code": "US",
            "telephone_number": "910-904-8000 x56949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMETA",
        "first_name": "MICHAEL",
        "middle_name": "TOBEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2023-01286",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "KOME3968700",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "VA",
            "license": "0101249428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700042231",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.