NPIMap

Individual provider Active NPI

Jack L Siegel, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Virginia Beach, VA
National Provider Identifier
1770512006
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
0101042155 Issued in VA
Practice address
5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784
Phone
(757) 502-8570
Fax
(757) 961-9767
NPI assigned
Jun 30, 2006
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101042155 VA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101042155 VA Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101042155 VA

Addresses

Primary practice location

5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784

Mailing address

5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784
Phone (757) 502-8570

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
I20100330000921 VA Practitioner - Orthopedic Surgery 7113939521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albany Medical College of Union University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethesda Chevy Chase Orthopaedic Associates, LLCGroup PAC ID 4789631011, 138 clinicians

Practice addresses (Care Compare)

5716 Cleveland St
Suite 200
Virginia Beach, VA 23462-1784
Phone (757) 490-4802

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.96 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
63.21

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as individual
Quality
73.79
Promoting interoperability
100
Improvement activities
40
Cost
71.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement27
Knee replacement63
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101042155VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan-Young Inst for Joint Reconstruction and Sports Medicine, LLC Orthopaedic Surgery CurrentSince Jan 1, 2004 Accepting new patients
Jordan Young Institute Current Accepting new patients
Bethesda Chevy Chase Orthopaedic Associates, LLC Orthopaedic Surgery CurrentSince Jan 1, 2024 Accepting new patients
Bethesda Chevy Chase Orthopaedic Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1133 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 496-2050

5716 Cleveland St
Virginia Beach, VA 23462
Phone (260) 494-6497

5716 Cleveland St
Ste 200
Virginia Beach, VA 23462
Phone (757) 502-8583

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

Hospital & facility affiliations 8

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1770512006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 CLEVELAND ST",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621784",
            "telephone_number": "757-502-8570",
            "fax_number": "757-961-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 CLEVELAND ST",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621784",
            "telephone_number": "757-502-8570",
            "fax_number": "757-961-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JACK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101042155",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101042155",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101042155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.