Gary Richard Siegel, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101035397 Issued in VA

Practice address

933 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-3172

Phone

(757) 491-7359

Fax

(757) 491-9359

NPI assigned

Oct 6, 2005

Last updated

Apr 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

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  Specialist

  Medicare reassignment NPD

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1952398778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-491-7359",
            "fax_number": "757-491-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-491-7359",
            "fax_number": "757-491-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "GARY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101035397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/MDIPA/OPC/MAMSI",
            "identifier": "228987",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID",
            "identifier": "7906796",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "006064833",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA/SENTARA",
            "identifier": "97565",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTHKEEPERS",
            "identifier": "030161",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006064833",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "030161",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Shupert, M.S., OTR/L
• Kali Marie Shy
• Nicole Sibiga, CFO
• Karen Elizabeth Sickenger, MD
• Kathryn Sidrow
• Jack L Siegel, M.D.
• Kenneth A Siegel, PHD
• Jeremy Peter Siegrist, M.D.
• William Alvin Sievert
• Sherry Renee Sigafoos, LPC,LMFT,LSATP,CSAC

• Specialist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; 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.

Verify at the official NPI Registry.