Individual provider Active NPI

George Robert Cheeseman IV, MD

  • Pediatric Radiology Physician
  • Travis Afb, CA
National Provider Identifier
1912535279
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
0101275046 Issued in VA
Practice address
60 MDG/SGQQ
101 Bodin Cir.
Travis Afb, CA 94535-1809
Phone
(707) 423-7208
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 0101275046 VA Primary

Addresses

Primary practice location

60 MDG/SGQQ
101 Bodin Cir.
Travis Afb, CA 94535-1809

Mailing address

60 MDG/SGQQ
101 Bodin Cir.
Travis Afb, CA 94535-1809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200609001814 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9234550799
I20210707000078 VA Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 9234550799

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: gcheeseman486251@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1912535279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MDG/SGQQ",
            "address_2": "101 BODIN CIR.",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MDG/SGQQ",
            "address_2": "101 BODIN CIR.",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEESEMAN",
        "first_name": "GEORGE",
        "middle_name": "ROBERT",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2026-08-02",
        "certification_date": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "VA",
            "license": "0101275046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.