Individual provider Active NPI

Jerry Francis Xavier Cushman, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1851370167
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101241081 Issued in VA
Practice address
5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone
(757) 473-3969
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101241081 VA Primary

Addresses

Primary practice location

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (757) 473-3969

Other practice location 1

2513 Hunting Horn Way
Virginia Beach, VA 23456-5209
Phone (757) 301-7837

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
I20070713000103 VA Practitioner - Family Practice 7315047834

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

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

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1851370167",
    "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": "757-473-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2513 Hunting Horn Way",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234565209",
            "country_code": "US",
            "telephone_number": "757-301-7837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "JERRY",
        "middle_name": "FRANCIS XAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101241081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.