Individual provider Active NPI

William Agustine Delacey, MD

  • Cardiovascular Disease Physician
  • Suffolk, VA
National Provider Identifier
1942265889
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101047940 Issued in VA
Practice address
2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone
(757) 925-0759
Fax
(757) 510-9436
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101047940 VA Primary

Addresses

Primary practice location

2000 Meade Pkwy
Suffolk, VA 23434-4259

Mailing address

2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 925-0759

Other identifiers 3

IdentifierTypeStateIssuer
6009590MedicaidVA
7906603MedicaidNC
060024220OtherVARAILROAD MEDICARE

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
I20060602000128 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac Electrophysiology 2062477672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101047940VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Medical Center, Inc Current Accepting new patients
Sentara Medical Group Cardiovascular Disease CurrentSince May 1, 2012 Accepting new patients

Locations

20209 Sentara Way
Carrollton, VA 23314
Phone (757) 357-5307

5659 Parkway Dr
Ste 200
Gloucester, VA 23061
Phone (757) 259-0443

5659 Parkway Dr
Ste 220
Gloucester, VA 23061
Phone (757) 736-7280

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

919 S Church St
Smithfield, VA 23430
Phone (757) 357-3291

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

Interoperability endpoints

  • Direct secure messaging: wdelacey33457@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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1942265889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-925-0759",
            "fax_number": "757-510-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-925-0759",
            "fax_number": "757-510-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACEY",
        "first_name": "WILLIAM",
        "middle_name": "AGUSTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101047940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6009590",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7906603",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060024220",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.