Coastal Surgical Specialists, PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

COASTAL SURGICAL SPECIALISTS, PC

Practice address

1120 First Colonial Rd
Suite 203
Virginia Beach, VA 23454-2418

Phone

(757) 481-4424

Fax

(757) 481-3820

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Basil S Skenderis II, M.D.

Title

Physician Administrator

Phone

(757) 481-4424

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1740345149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 203",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-481-4424",
            "fax_number": "757-481-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 FIRST COLONIAL RD",
            "address_2": "SUITE 203",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542418",
            "telephone_number": "757-481-4424",
            "fax_number": "757-481-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SURGICAL SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "SKENDERIS",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN ADMINISTRATOR",
        "authorized_official_telephone_number": "757-481-4424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA VENDER #",
            "identifier": "300012",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5975074",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013HR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Plastic Surgery LTD
• Coastal Podiatry, Inc
• Coastal Prosthetics and Orthotics, LLC
• Coastal Prosthetics and Orthotics, LLC
• Coastal Smiles, PLLC
• Coastal Therapy Group Inc
• Coastal Tranquility Behavioral Health LLC
• Coastal Urology, P.C.
• Coastal Virginia Endodontics PLLC
• Coastal Virginia Mental Health Services PLLC

• Specialist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.