Individual provider Active NPI

Kevin Wayne Hynes, PA-C

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1851003628
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009485 Issued in VA
Practice address
680 Oyster Point Rd
Newport News, VA 23606-4570
Phone
(757) 668-4851
NPI assigned
Dec 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X VA
Physician Assistant 363A00000X 0110009485 VA Primary

Addresses

Primary practice location

680 Oyster Point Rd
Newport News, VA 23606-4570

Mailing address

825 Fairfax Ave
Norfolk, VA 23507-1912
Phone (757) 618-8545

Other practice location 1

3960 Virginia Beach Blvd
Virginia Beach, VA 23452-2449
Phone (757) 668-4648

Other practice location 2

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other practice location 3

825 Fairfax Ave
Norfolk, VA 23507-1912
Phone (757) 446-5600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260323001985 VA Practitioner - Physician Assistant 4789168238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

601 Childre'S LN
Norfolk, VA 23507-1910

601 Childrens LN
Norfolk, VA 23507-1971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110009485VAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697846400000",
    "number": "1851003628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071912",
            "telephone_number": "757-618-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 OYSTER POINT RD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064570",
            "telephone_number": "757-668-4851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3960 Virginia Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234522449",
            "country_code": "US",
            "telephone_number": "757-668-4648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202855",
            "country_code": "US",
            "telephone_number": "757-668-4630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Fairfax Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071912",
            "country_code": "US",
            "telephone_number": "757-446-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYNES",
        "first_name": "KEVIN",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-23",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.