NPIMap

Individual provider Active NPI

Debra Marie Sequeira, MD

  • Family Medicine Physician
  • Amelia, VA
National Provider Identifier
1851373559
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101237193 Issued in VA
Practice address
8920 Otterburn Road
Amelia, VA 23002
Phone
(804) 561-5150
Fax
(804) 561-6643
NPI assigned
Nov 17, 2005
Last updated
Mar 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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 0101237193 VA Primary

Addresses

Primary practice location

8920 Otterburn Road
Amelia, VA 23002

Mailing address

PO Box 70
Victoria, VA 23974-0070
Phone (434) 696-2165

Other identifiers 1

IdentifierTypeStateIssuer
010192854MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000412 VA Practitioner - Family Practice 1355249392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1418 6TH St
Victoria, VA 23974-0070
Phone (434) 696-4180

8920 Otterburn Rd
Amelia Court House, VA 23002-4854
Phone (434) 696-2165

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101237193VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dominion Health System, Inc. CurrentSince Jan 30, 2018 Accepting new patients

Locations

8920 Otterburn Rd
Amelia Ct Hse, VA 23002
Phone (804) 288-8838

13855 Courthouse Rd
Dinwiddie, VA 23841
Phone (804) 469-3731

510 N Main St
Emporia, VA 23847
Phone (434) 634-7723

1508 K V Rd
Victoria, VA 23974
Phone (434) 696-2165

Interoperability endpoints

  • Direct secure messaging: debra.sequeira@sdhs.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1851373559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 OTTERBURN ROAD",
            "city": "AMELIA",
            "state": "VA",
            "postal_code": "23002",
            "telephone_number": "804-561-5150",
            "fax_number": "804-561-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101237193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010192854",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amelia, VA

Sources for this page

Verify at the official NPI Registry.