NPIMap

Organization Active NPI

Family Medicine Healthcare PLLC

  • Family Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1730133398
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101235873 Issued in VA
Legal business name
FAMILY MEDICINE HEALTHCARE PLLC
Practice address
3925 Portsmouth Blvd
Chesapeake, VA 23321-3624
Phone
(757) 488-3333
Fax
(757) 488-0007
NPI assigned
May 19, 2006
Last updated
May 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Authorized official

Name
Samir Tawfik Abdelshaheed, M.D.NPI 1598720245
Title
Owner/ Physician
Phone
(757) 488-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 0101235873 VA Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 0101028352 VA

Addresses

Primary practice location

3925 Portsmouth Blvd
Chesapeake, VA 23321-3624

Mailing address

3925 Portsmouth Blvd
Chesapeake, VA 23321-3624
Phone (757) 488-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060411000746 VA Part B Supplier - Clinic/Group Practice 7315956828 Receives reassigned benefits from 8 practitioners
Practice locations: Chesapeake, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1051521Family Medicine Healthcare3925 Portsmouth Boulevard, Chesapeake, VA 23321AccreditationNov 18, 2027

National Provider Directory

National Provider Directory

Locations

3925 Portsmouth Blvd
Chesapeake, VA 23321
Phone (757) 488-3333

6111 Portsmouth Blvd
Portsmouth, VA 23701
Phone (757) 488-3333

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73278

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620432000000",
    "number": "1730133398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 PORTSMOUTH BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213624",
            "telephone_number": "757-488-3333",
            "fax_number": "757-488-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 PORTSMOUTH BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213624",
            "telephone_number": "757-488-3333",
            "fax_number": "757-488-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A",
        "authorized_official_last_name": "ABDELSHAHEED",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "TAWFIK",
        "authorized_official_title_or_position": "OWNER/ PHYSICIAN",
        "authorized_official_telephone_number": "757-488-3333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101235873",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101028352",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.