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DR. PHILLIP B. DUNCAN M.D.
NPI 1215067509
Internal Medicine - Cardiovascular Disease in Chester, VA

Active since March 06, 2007PECOS EnrolledAccepts Medicare Assignment
76.23/100
CMS Quality Rating
281 E HUNDRED RD, CHESTER, VA 23836(804) 530-5178(804) 530-5185 Get Directions Write a Review

NPPES record last updated: March 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Phillip B. Duncan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PHILLIP B. DUNCAN M.D. (NPI 1215067509) is an individual cardiovascular disease provider in Chester, Virginia, licensed in Virginia (0101035649) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Medical College Of Virginia Hospitals, and is a graduate of Howard University College Of Medicine (1978).

NPPES Registry Identity

NPI1215067509
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. PHILLIP B. DUNCANCredential: M.D.
Location Address281 E HUNDRED RDChester, VA 23836-2613
Mailing Address281 E Hundred RdChester, VA 23836-2613 · (804) 530-5178 · Fax (804) 530-5185
Phone(804) 530-5178
Fax(804) 530-5185
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 1978
Enumeration DateMarch 6, 2007
Last NPPES UpdateMarch 13, 2024
NPPES CertifiedMarch 13, 2024
✔ NPI 1215067509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in VA · 0101035649
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedSpecialistTaxonomy 174400000X · License 0101035649 (VA)
281 E HUNDRED RD, Chester, VA 23836
Open in Google Maps ↗

Other Identifiers 1

Medicaid005817986VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Phillip B. Duncan M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890842033
PECOS Enrollment IDI20100823001052
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Phillip Duncan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mcv Associated Physicians
14 mi
Anesthesiology
1250 E MARSHALL ST, MAIN 1-214, BOX 980510
Richmond, VA 23298
  • Reassigned Medicare billing, Virginia enrollment
  • 2,481 clinicians in this Medicare group
NPI 1710959457 (804) 828-8707
Chippenham & Johnston-Willis Hospitals, Inc.
15 mi
Electrodiagnostic Medicine
7101 JAHNKE RD
Richmond, VA 23225
  • Reassigned Medicare billing, Virginia enrollment
  • 53 clinicians in this Medicare group
NPI 1033596416 (804) 320-3911

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
271 services81 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
49 services47 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
40 services39 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
40 services39 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
38 services20 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
31 services29 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Medical College Of Virginia Hospitals

Acute Care Hospitals · Richmond, VA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number490032
LocationPost Office Box 980510 1250 East Marshall StreetRichmond, VA 23298 · Richmond City County
Emergency services Birthing friendly

Vcu Health Tappahannock Hospital

Acute Care Hospitals · Tappahannock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490084
Location618 Hospital RoadTappahannock, VA 22560 · Essex County
Emergency services

Community Memorial Hospital

Acute Care Hospitals · South Hill, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490098
Location1755 North Mecklenburg AvenueSouth Hill, VA 23970 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23836 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.58
Promoting Interoperability100
Improvement Activities40
Cost56.18

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUNNY KAMLESH BRAHMBHATT MD
Family Medicine (Sports Medicine)
281 E HUNDRED RD
CHESTER, VA 23836
Chesterfield County (804) 796-2373
PT SOLUTIONS CHESTER, PLLC
Clinic/Center (Physical Therapy)
281 E HUNDRED RD
CHESTER, VA 23836
Chesterfield County (804) 569-1787

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip Duncan's NPI number?

The NPI number for Phillip Duncan is 1215067509. It was assigned to this individual provider in the NPPES registry on March 6, 2007.

Where is Phillip Duncan located?

Phillip Duncan practices at 281 E Hundred Rd, Chester, VA 23836. The listed phone number is (804) 530-5178.

What is Phillip Duncan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Phillip Duncan enrolled in Medicare?

Yes. Phillip Duncan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Phillip Duncan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Duncan reassigns Medicare benefits to 2 organizations: Mcv Associated Physicians (Richmond, VA) and Chippenham & Johnston-Willis Hospitals, Inc. (Richmond, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phillip Duncan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Phillip Duncan accept?

Health plans from Oscar Health list Phillip Duncan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Phillip Duncan affiliated with any hospitals?

According to CMS data, Phillip Duncan is affiliated with Medical College Of Virginia Hospitals, Vcu Health Tappahannock Hospital and Community Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Phillip Duncan was last updated on March 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.