ALLEN R. FENDERSON (M.D.) – Family Medicine Physician, NPI 1205832979
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ALLEN R. FENDERSON (M.D.)
351, Edwin Drive, Virginia Beach, Virginia, 23452, United States
STE 102
VIRGINIA BEACH, VA 234624559
Phone: (757) 499-5550
Type: Location
860, Omni Boulevard, City Center, Newport News, Newport News City, Virginia, 23606, United States
STE 101
NEWPORT NEWS, VA 236064430
Phone: (757) 232-8769
Fax: (757) 232-8875
Type: Mailing
860 OMNI BLVD STE 101
NEWPORT NEWS, VA 236064430
Phone: (757) 232-8769
Fax: (757) 232-8875
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-03-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100329000477 | I | Family Practice | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 23462)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | VA | 90670 | Pneumococcal vaccine for injection into muscle | 61 | 61 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VA | |
| Family Practice | VA | |
| - | VA | |
| Family Practice | VA | |
| Family Practice | VA | |
| - | VA | |
| Nurse Practitioner | VA | |
| - | VA | |
| - | VA | |
| N E U R O L O G Y | VA |
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