Individual provider Active NPI

Michael Leary

  • Acute Care Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1962021576
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024178745 Issued in VA
Practice address
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone
(757) 507-1000
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024178745 VA Primary

Addresses

Primary practice location

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178

Mailing address

4340 Silverleaf CT
Virginia Beach, VA 23462-5738
Phone (757) 753-6750

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
I20200623003099 VA Practitioner - Nurse Practitioner 6800218637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024178745VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jul 1, 2020 Accepting new patients
Bayview Physician Services, PC CurrentSince Nov 1, 2024 Accepting new patients
Bayview Physician Services, PC CurrentSince Nov 1, 2024 Accepting new patients

Locations

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

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

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

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

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1962021576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 SILVERLEAF CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625738",
            "telephone_number": "757-753-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GLENN MITCHELL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560178",
            "telephone_number": "757-507-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024178745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.