Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kiran Jyoti De Jesus

Individual provider Physician Assistant · NPI 1023663622

Kiran Jyoti De Jesus is a Physician Assistant in Newport News, Virginia. Qualified in 2019, 7 years ago. Practices with Tidewater Physicians Multispecialty Group, PC, a 269-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
7
Licensed in
VA
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

860 Omni Blvd Ste 111
Newport News, VA 23606-4430
Phone: (757) 369-8138
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5160 S John Young Pkwy, Orlando, FL 32839-5022 — (844) 665-4827
  • 4001 Coliseum Dr Ste 310a, Hampton, VA 23666-6257 — (757) 736-2540

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 0110010497 (VA)

Record details

NPI number1023663622
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 9, 2019
Last updated in NPPESJanuary 15, 2026
Certification dateJanuary 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Tidewater Physicians Multispecialty Group, Pc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Newport News