Individual provider Active NPI

Ian Persaud, M.D

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1770761793
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101253200 Issued in VA
Practice address
549 E Brambleton Ave
Norfolk, VA 23510-2905
Phone
(757) 533-9441
Fax
(757) 446-1454
NPI assigned
Jan 31, 2008
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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 0101253200 VA Primary
Cardiovascular Disease Physician 207RC0000X 0213001912 VA

Addresses

Primary practice location

549 E Brambleton Ave
Norfolk, VA 23510-2905

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (757) 533-9441

Other practice location 1

48 Newmarket Sq
Newport News, VA 23605-2721
Phone (305) 621-0023

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
I20130404000284 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618112186 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

346 W Freemason St
Norfolk, VA 23510-1219
Phone (347) 523-1750

6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0213001912VAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Apr 1, 2021 Accepting new patients
Mid-Atlantic Post Acute & Long Term Care PLLC Internal Medicine CurrentSince Apr 25, 2025 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Apr 25, 2025 Accepting new patients
Heartwell Health, PLLC Cardiovascular Disease CurrentSince Apr 28, 2024 Accepting new patients
PMR Meds PastSince Feb 8, 2015 Accepting new patients

Locations

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

524 Southpark Blvd
Colonial Hgts, VA 23834
Phone (804) 504-7980

48 Newmarket Sq
Newport News, VA 23605
Phone (757) 825-8030

549 E Brambleton Ave
Norfolk, VA 23510
Phone (757) 393-1136

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

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 5

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 2

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": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1770761793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "757-533-9441",
            "fax_number": "757-446-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 E BRAMBLETON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102905",
            "telephone_number": "757-533-9441",
            "fax_number": "757-446-1454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Newmarket Sq",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236052721",
            "country_code": "US",
            "telephone_number": "305-621-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "IAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253200",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0213001912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.