Individual provider Active NPI

Mark J Kanter, MD

  • Specialist
  • Hampton, VA
National Provider Identifier
1801810866
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101041391 Issued in VA
Practice address
4000 Coliseum Dr
Ste 110
Hampton, VA 23666-5906
Phone
(757) 827-8486
Fax
(757) 827-8718
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101041391 VA Primary

Addresses

Primary practice location

4000 Coliseum Dr
Ste 110
Hampton, VA 23666-5906

Mailing address

860 Omni Blvd
Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

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
I20101215001244 VA Practitioner - Plastic and Reconstructive Surgery 2769679034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Eastern Virginia Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision58
Removal of tissue1-10
Skin biopsy15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101041391VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince May 1, 2016 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince May 1, 2016 Accepting new patients

Locations

4000 Coliseum Dr
Ste 110
Hampton, VA 23666
Phone (757) 827-8486

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1801810866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 COLISEUM DR",
            "address_2": "STE 110",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665906",
            "telephone_number": "757-827-8486",
            "fax_number": "757-827-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTER",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101041391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.