Mid Atlantic Healthcare Services PC

Key facts

NPI

1992632087

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

Legal business name

MID ATLANTIC HEALTHCARE SERVICES PC

Practice address

340 Lynn Shores Dr
Virginia Beach, VA 23452-2416

Phone

(212) 734-6621

NPI assigned

May 5, 2026

Organization subpart

No

Authorized official

Name

Simon Fensterszaub NPI 1003077322

Title

DO

Phone

(917) 863-8499

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simon Fensterszaub, D.O. Family Medicine Physician · Bristol, RI · NPI 1003077322
  Medicare reassignment Authorized official VA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in VA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 5, 2026.

{
    "created_epoch": "1777939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1992632087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 203",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087550954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 LYNN SHORES DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234522416",
            "telephone_number": "212-734-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC HEALTHCARE SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "FENSTERSZAUB",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "917-863-8499"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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