Individual provider Active NPI

Emily Lisbeth Bosch, MMS, PA-C

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1881917557
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002786 Issued in VA
Practice address
600 Gresham Dr Ste 204
Norfolk, VA 23507-1904
Phone
(757) 388-5680
Fax
(757) 388-5681
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002786 VA Primary

Addresses

Primary practice location

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904
Phone (757) 388-5680

Other practice location 1

1080 First Colonial Rd
Virginia Beach, VA 23454-2406
Phone (757) 388-5680

Other names 1

  • Emily Lisbeth Alves Other name

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
I20100802000069 VA Practitioner - Physician Assistant 0143353896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-2323

1080 1St Colonial Rd
Virginia Beach, VA 23454-2406

600 Gresham Dr
Norfolk, VA 23507-1904

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jul 5, 2010 Accepting new patients

Locations

600 Gresham Dr
Ste 200
Norfolk, VA 23507

600 Gresham Dr
Ste 204
Norfolk, VA 23507
Phone (757) 388-5680

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

1080 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 388-5680

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

Interoperability endpoints

  • Direct secure messaging: ebosch505@direct.sentara.net

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 and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1881917557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680",
            "fax_number": "757-388-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680",
            "fax_number": "757-388-5681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1080 First Colonial Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234542406",
            "country_code": "US",
            "telephone_number": "757-388-5680",
            "fax_number": "757-388-5681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSCH",
        "first_name": "EMILY",
        "middle_name": "LISBETH",
        "name_prefix": "Mrs.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ALVES",
            "middle_name": "LISBETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.