NPIMap

Individual provider Active NPI

Michael Nussbaum, MD

  • Surgery Physician
  • Roanoke, VA
National Provider Identifier
1972571669
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101262004 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 224-5170
Fax
(540) 983-8213
NPI assigned
Mar 9, 2006
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101262004 VA Primary

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Other identifiers 2

IdentifierTypeStateIssuer
0000539-00MedicaidFL
880631957AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnussbaum88798@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081111000531 FL Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 2668470238 Reassigns benefits to 1 organization
I20170420000044 VA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 2668470238 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Perelman School of Med at the University of Pennsylvania, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Apr 7, 2017 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Surgery Current Accepting new patients
Carilion Giles Community Hospital CurrentSince Nov 16, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 16, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince Nov 16, 2017 Accepting new patients
University of Florida Jacksonville Physicians Inc Surgery CurrentSince Jul 1, 2008 Accepting new patients
Carilion Giles Community Hospital CurrentSince Nov 16, 2017 Accepting new patients
Carilion Medical Center CurrentSince Apr 7, 2017 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2008 Accepting new patients
Carilion Medical Center Past Accepting new patients
University of Cincinnati Surgeons, Inc. Surgery Past Accepting new patients
West Chester Hospital LLC Past Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

3 Riverside Cir
Roanoke, VA 24016

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: mnussbaum88798@direct.carilionclinic.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carilion Roanoke Community HospitalRoanoke, VA, CCN 49S024 Hospital Corporate Officer Oct 1, 2021
Carilion Roanoke Community HospitalRoanoke, VA, CCN 49T024 Hospital Corporate Officer Oct 1, 2021
Carilion Medical Center Home HealthRoanoke, VA, CCN 497258 Home health agency Corporate Director Oct 1, 2023
Carilion Hospice Services of RoanokeRoanoke, VA, CCN 491515 Hospice Corporate Director Oct 1, 2021

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1972571669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5170",
            "fax_number": "540-983-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101262004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000539-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880631957A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnussbaum88798@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mnussbaum88798@direct.carilionclinic.org",
            "address_1": "3 Riverside Cir",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.