Individual provider Active NPI

Michael Scott Mynes, M.D.

  • Anesthesiology Physician
  • Portsmouth, VA
National Provider Identifier
1821211665
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101242161 Issued in VA
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 390-1571
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20704 WV
Anesthesiology Physician 207L00000X 0101242161 VA Primary

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-3832

Other identifiers 5

IdentifierTypeStateIssuer
P01036106OtherVARAILROAD MEDICARE
3810011144MedicaidWV
1821211665OtherWVMOUNTAIN STATE BLUE CROSS BLUE SHIELD
1821211665MedicaidVA
270052997OtherWVHEALTHNET/TRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20091208000710 VA Practitioner - Anesthesiology 0941383889 Reassigns benefits to 2 organizations
I20251111000511 NC Practitioner - Anesthesiology 0941383889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dogwood Anesthesia Providers LLCGroup PAC ID 2769853084, 141 clinicians

Practice addresses (Care Compare)

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (804) 520-8272

Hospital & facility affiliations

  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20704WVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dogwood Anesthesia Providers, LLC Anesthesiology CurrentSince Nov 21, 2025 Accepting new patients
SMG Anesthesia Specialists LLC Anesthesiology CurrentSince Jan 27, 2026 Accepting new patients
University of North Carolina at Chapel Hill Anesthesiology CurrentSince Aug 26, 2025 Accepting new patients
Mid-Atlantic Anesthesia Consultants, LLC Anesthesiology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

1700 Will O Wisp Dr
Virginia Beach, VA 23454
Phone (757) 213-4320

816 Independence Blvd
Ste 2G
Virginia Beach, VA 23455
Phone (757) 363-6230

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.

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1821211665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-3832",
            "fax_number": "516-945-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-390-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNES",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "20704",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101242161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01036106",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011144",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BLUE CROSS BLUE SHIELD",
            "identifier": "1821211665",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821211665",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET/TRICARE",
            "identifier": "270052997",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.