NPIMap

Individual provider Active NPI

Sanford Kent Marcuson, M.D.

  • Internal Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1710952676
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101227468 Issued in VA
Practice address
6601 Mooretown Rd
Suite 400
Williamsburg, VA 23188-2196
Phone
(757) 645-3150
NPI assigned
Feb 22, 2006
Last updated
Oct 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101227468 VA Primary

Addresses

Primary practice location

6601 Mooretown Rd
Suite 400
Williamsburg, VA 23188-2196

Mailing address

860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 7

IdentifierTypeStateIssuer
P00315325OtherRR/MEDICARE
0403049OtherVAUNITED HEALTHCARE
454080OtherVAANTHEM BLUE CROSS BLUE SH
005870411MedicaidVA
0410632001OtherVACIGNA HEALTHCARE
133641808OtherVATRICARE
29088OtherVASENTARA/OPTIMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060714000192 VA Practitioner - Internal Medicine 6507760683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

132 Professional Cir
Williamsburg, VA 23185-3374
Phone (757) 232-8764

400 Sentara Cir
Suite 400
Williamsburg, VA 23188-5716
Phone (757) 645-3150

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue284
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101227468VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jul 1, 2006 Accepting new patients
Healogics Specialty Physicians of Virginia, LLC CurrentSince Feb 18, 2019 Accepting new patients
Tidewater Physicians Multispecialty Group PC Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

132 Professional Cir
Williamsburg, VA 23185
Phone (757) 232-8764

400 Sentara Cir
Williamsburg, VA 23188
Phone (757) 345-4080

400 Sentara Cir
Ste 400
Williamsburg, VA 23188
Phone (757) 645-3150

14010 Smoketown Rd
Ste 103
Woodbridge, VA 22192
Phone (571) 402-7322

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1710952676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 MOORETOWN RD",
            "address_2": "SUITE 400",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882196",
            "telephone_number": "757-645-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUSON",
        "first_name": "SANFORD",
        "middle_name": "KENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101227468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "P00315325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0403049",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "454080",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005870411",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "0410632001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "133641808",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "29088",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.