Individual provider Active NPI

Amorsolo Laja Suguitan Jr., MD, MSC, PHD

  • Internal Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1740711241
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101280687 Issued in VA
Practice address
5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone
(757) 473-3969
Fax
(757) 506-0157
NPI assigned
Mar 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20140 NV
Internal Medicine Physician 207R00000X 0101280687 VA Primary

Addresses

Primary practice location

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629

Mailing address

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone (757) 473-3969

Other practice location 1

Howard University Hospital
2041 Georgia Avenue
Washington, DC 20060-0001
Phone (202) 865-6100

Other identifiers 2

IdentifierTypeStateIssuer
1740711241MedicaidNV
20140OtherNVSTATE LICENSE

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208001555 VA Practitioner - Internal Medicine 5193001139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Virginia Holding LLCGroup PAC ID 9537576608, 19 clinicians

Practice addresses (Care Compare)

3806 Mechanicsville Tpke
Richmond, VA 23223-1114
Phone (804) 228-1143

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Dec 1, 2023 Accepting new patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
Jencare Neighborhood Medical East Richmond, LLC Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Jencare Neighborhood Medical Center Virginia Beach LLC Internal Medicine CurrentSince Dec 3, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

Organizations & group practices 4

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": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1740711241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Howard University Hospital",
            "address_2": "2041 Georgia Avenue",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUGUITAN",
        "first_name": "AMORSOLO",
        "middle_name": "LAJA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "20140",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101280687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740711241",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20140",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.