Individual provider Active NPI

Mariya V. George, D.O.

  • Emergency Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1982020145
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102204311 Issued in VA
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 953-1407
NPI assigned
Mar 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102204311 VA Primary

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

475 Water St
Apt 606
Portsmouth, VA 23704-3819

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
I20181009001068 VA Practitioner - Emergency Medicine 5496044653 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Emergency Medical Care, LTD. Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 Accepting new patients

Locations

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

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": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1982020145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 WATER ST",
            "address_2": "APT 606",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MARIYA",
        "middle_name": "V.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102204311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.