Individual provider Active NPI

Ehsun Raza Mirza, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Newport News, VA
National Provider Identifier
1821049735
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
0101271120 Issued in VA
Practice address
12200 Warwick Blvd Ste 290
Newport News, VA 23601-2344
Phone
(757) 534-5454
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101271120 VA Primary

Addresses

Primary practice location

12200 Warwick Blvd Ste 290
Newport News, VA 23601-2344

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

115 Cass Ave
Woonsocket, RI 02895-4705
Phone (401) 766-2970 ext. 101

Other identifiers 1

IdentifierTypeStateIssuer
7010558MedicaidRI

Other names 1

  • Ahsan Raza Mahmood Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emirza20350@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20070824000639 RI Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 6103918826 Reassigns benefits to 1 organization
I20150929000048 MA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 6103918826 Reassigns benefits to 1 organization
I20210112002476 VA Practitioner - Critical Care (Intensivists) 6103918826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

12200 Warwick Blvd
Suite 290
Newport News, VA 23601-2344
Phone (757) 534-5454

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jan 11, 2021 Accepting new patients
Riverside Physician Services, Inc. CurrentSince Jan 11, 2021 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Hni Medical Services CurrentSince Sep 1, 2015 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 17, 2015 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 17, 2015 Accepting new patients
The Miriam Hospital Past Accepting new patients

Locations

75 Remittance Dr
Dept 1653
Chicago, IL 60675

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

12200 Warwick Blvd
Ste 290
Newport News, VA 23601
Phone (757) 534-5454

Interoperability endpoints

  • Direct secure messaging: emirza20350@direct.southcoast.org

Organizations & group practices 7

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1821049735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WARWICK BLVD STE 290",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012344",
            "telephone_number": "757-534-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954705",
            "country_code": "US",
            "telephone_number": "401-766-2970 x101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "EHSUN",
        "middle_name": "RAZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101271120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7010558",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emirza20350@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "101 Page St",
            "city": "New Bedford",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027403464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AHSAN",
            "last_name": "MAHMOOD",
            "middle_name": "RAZA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.