Active NPI
Jerry Francis Xavier Cushman, M.D.
- Family Medicine Physician
- Virginia Beach, VA
National Provider Identifier
1851370167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101241081
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070713000103 | VA | Practitioner - Family Practice | 7315047834 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PMR Virginia Holding, LLC | Current | 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.
-
- Specialist
- Miami Gardens, FL
- NPI 1083167001
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.