| Jencare Neighborhood Medical Center Virginia Beach Llc | |
|
5516 Virginia Beach Blvd Virginia Beach VA 23462-5629 | |
| (305) 628-6117 | |
| Not Available |
| Full Name | Jencare Neighborhood Medical Center Virginia Beach Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5516 Virginia Beach Blvd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Mary Chen (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3058314722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jencare Neighborhood Medical Center Virginia Beach Llc 1395 Nw 167th St Miami Gardens FL 33169-5710 Ph: (305) 628-6117 | Jencare Neighborhood Medical Center Virginia Beach Llc 5516 Virginia Beach Blvd Virginia Beach VA 23462-5629 Ph: (305) 628-6117 |
| NPI Number | 1770924789 |
|---|---|
| Provider Enumeration Date | 07/08/2013 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 8921236167 |
|---|---|
| Medicare Enrollment ID | O20140114001303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770924789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 3336C0003X | Pharmacy - Community/retail Pharmacy | (* (Not Available)) | Secondary |
| Provider Name | Bruce M Bradfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629046214 PECOS PAC ID: 3577516392 Enrollment ID: I20050222000155 |
| Provider Name | Daniel M Jannuzzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518924950 PECOS PAC ID: 9537105267 Enrollment ID: I20050705000562 |
| Provider Name | Jasdeep Dalawari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215986807 PECOS PAC ID: 1759275167 Enrollment ID: I20050901000604 |
| Provider Name | Sophie Parker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760416796 PECOS PAC ID: 8426075078 Enrollment ID: I20051102000202 |
| Provider Name | Maryam M Nowroozi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306807201 PECOS PAC ID: 3274555149 Enrollment ID: I20051221000030 |
| Provider Name | Daniel F Mccarter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932278561 PECOS PAC ID: 0143238642 Enrollment ID: I20060324000355 |
| Provider Name | Luanne K Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760466759 PECOS PAC ID: 9133184856 Enrollment ID: I20070123000226 |
| Provider Name | Daniel C Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992730642 PECOS PAC ID: 5496757098 Enrollment ID: I20070212000185 |
| Provider Name | Luther L Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285705228 PECOS PAC ID: 5294831467 Enrollment ID: I20070503000659 |
| Provider Name | Jerry F Cushman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851370167 PECOS PAC ID: 7315047834 Enrollment ID: I20070713000103 |
| Provider Name | Lisa Price Stevens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063488807 PECOS PAC ID: 6204924996 Enrollment ID: I20071113000786 |
| Provider Name | Ruby M Tucker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194925545 PECOS PAC ID: 9032273149 Enrollment ID: I20090203000701 |
| Provider Name | Minhtam Thai |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659519429 PECOS PAC ID: 9133279433 Enrollment ID: I20090608000575 |
| Provider Name | Samamtha Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033340377 PECOS PAC ID: 9436297645 Enrollment ID: I20091109000559 |
| Provider Name | Imtiaz Zaman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013078286 PECOS PAC ID: 6103968367 Enrollment ID: I20100126000642 |
| Provider Name | Vincent Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013062579 PECOS PAC ID: 0446393672 Enrollment ID: I20100210000101 |
| Provider Name | Lisa N Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346562212 PECOS PAC ID: 6002945698 Enrollment ID: I20100519000779 |
| Provider Name | John Michael Weil |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215902721 PECOS PAC ID: 8022057280 Enrollment ID: I20100806000444 |
| Provider Name | Gordon L Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912108317 PECOS PAC ID: 1456535665 Enrollment ID: I20110912000565 |
| Provider Name | Susan B Girois |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285922260 PECOS PAC ID: 3173796802 Enrollment ID: I20111025000680 |
| Provider Name | Prakash G Ettigi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326057597 PECOS PAC ID: 1456253863 Enrollment ID: I20111027000696 |
| Provider Name | Folashade O Alade |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578731600 PECOS PAC ID: 8325125164 Enrollment ID: I20120319000389 |
| Provider Name | Tamice Rachonne Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508029471 PECOS PAC ID: 6507027752 Enrollment ID: I20120413000655 |
| Provider Name | Carla Ines Acra Despradel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114181666 PECOS PAC ID: 6800050311 Enrollment ID: I20120613000674 |
| Provider Name | Ian Persaud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770761793 PECOS PAC ID: 7618112186 Enrollment ID: I20130404000284 |
| Provider Name | Bikram Saini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083844096 PECOS PAC ID: 6103069174 Enrollment ID: I20130823001050 |
| Provider Name | Michael J Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568441202 PECOS PAC ID: 0840434874 Enrollment ID: I20130913000072 |
| Provider Name | Malena Michelle Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902117039 PECOS PAC ID: 8729215751 Enrollment ID: I20131218000660 |
| Provider Name | Laurie Salerno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508829706 PECOS PAC ID: 4082788575 Enrollment ID: I20140922001253 |
| Provider Name | Rasheed A Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952531485 PECOS PAC ID: 1850539222 Enrollment ID: I20141103002540 |
| Provider Name | Nakeisha R Rodgers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679880843 PECOS PAC ID: 1355563677 Enrollment ID: I20141120001496 |
| Provider Name | Regina D Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437160546 PECOS PAC ID: 1456673110 Enrollment ID: I20141208001256 |
| Provider Name | Marc I Gaines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306819222 PECOS PAC ID: 5597080481 Enrollment ID: I20150218000263 |
| Provider Name | Pho Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194089714 PECOS PAC ID: 6608184106 Enrollment ID: I20151002001255 |
| Provider Name | Sailaja Dandamudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679869036 PECOS PAC ID: 5890946503 Enrollment ID: I20151015002177 |
| Provider Name | Claire H Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518222785 PECOS PAC ID: 2264741974 Enrollment ID: I20151020002746 |
| Provider Name | Elizabeth Carr |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568452977 PECOS PAC ID: 5193616357 Enrollment ID: I20151201000158 |
| Provider Name | Paola M Palomino Guillen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962703652 PECOS PAC ID: 6002074614 Enrollment ID: I20160216000411 |
| Provider Name | Andrew A Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790755510 PECOS PAC ID: 7618115049 Enrollment ID: I20160229002506 |
| Provider Name | Nikitia M Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275990715 PECOS PAC ID: 2466758503 Enrollment ID: I20160315002547 |
| Provider Name | Babak S Pirouz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609072578 PECOS PAC ID: 6103912118 Enrollment ID: I20160516001507 |
| Provider Name | Danielle Leigh Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376095489 PECOS PAC ID: 2365725140 Enrollment ID: I20170202001332 |
| Provider Name | Obianuju Amadi |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1538419759 PECOS PAC ID: 0244513414 Enrollment ID: I20170214000391 |
| Provider Name | Maryann Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184167900 PECOS PAC ID: 2961785183 Enrollment ID: I20170214002402 |
| Provider Name | Sailaja Kalidasu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861805756 PECOS PAC ID: 4587948328 Enrollment ID: I20170223000364 |
| Provider Name | Sophia A Khawly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144573056 PECOS PAC ID: 5698913754 Enrollment ID: I20170224002088 |
| Provider Name | Mehwish Moktader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528387149 PECOS PAC ID: 9739327859 Enrollment ID: I20170404001902 |
| Provider Name | Jose Hiram Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164554523 PECOS PAC ID: 2163548918 Enrollment ID: I20170522002136 |
| Provider Name | Patricia J Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073531604 PECOS PAC ID: 8921370198 Enrollment ID: I20170823000749 |
| Provider Name | Shari Lynn Samms |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245337500 PECOS PAC ID: 8921320565 Enrollment ID: I20170912003320 |
| Provider Name | Kashmal Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952718520 PECOS PAC ID: 1658644679 Enrollment ID: I20170913001193 |
| Provider Name | Wallisa T Vaughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992990238 PECOS PAC ID: 7618021502 Enrollment ID: I20170918002301 |
| Provider Name | Deanna Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598103129 PECOS PAC ID: 6800152760 Enrollment ID: I20171108002670 |
| Provider Name | Zakiya Sadeq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922448513 PECOS PAC ID: 0244502003 Enrollment ID: I20171115001854 |
| Provider Name | Regina Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588023279 PECOS PAC ID: 3870864465 Enrollment ID: I20171211000435 |
| Provider Name | Imhotep Boukman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326094723 PECOS PAC ID: 0244238343 Enrollment ID: I20171218001935 |
| Provider Name | Lacia Chapman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750482733 PECOS PAC ID: 3870745417 Enrollment ID: I20171227000707 |
| Provider Name | Belinda Ocampo Escanio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679624704 PECOS PAC ID: 0547454498 Enrollment ID: I20180119001923 |
| Provider Name | Aaron Stecker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457768939 PECOS PAC ID: 9436463452 Enrollment ID: I20180613000744 |
| Provider Name | Ashly Nicole Hardin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710220132 PECOS PAC ID: 4183910367 Enrollment ID: I20180626001164 |
| Provider Name | Martha B Alberti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063486785 PECOS PAC ID: 2961591334 Enrollment ID: I20180709002086 |
| Provider Name | Mahboobeh Memarsadeghi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336554468 PECOS PAC ID: 5193071934 Enrollment ID: I20180709002239 |
| Provider Name | Zainab Jalal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427430834 PECOS PAC ID: 4981917044 Enrollment ID: I20181002000003 |
| Provider Name | Shubha Lakshmi Bhat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831537729 PECOS PAC ID: 6002038940 Enrollment ID: I20181205000620 |
| Provider Name | Rikitha Menezes |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1447632559 PECOS PAC ID: 7113260100 Enrollment ID: I20190514002736 |
| Provider Name | Olisamemka I Achike |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558702159 PECOS PAC ID: 4981998770 Enrollment ID: I20190521000019 |
| Provider Name | Nadia Maria Echevarria Velez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871987883 PECOS PAC ID: 6709131832 Enrollment ID: I20191217000250 |
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