Tidewater Medical Care Pc - Medicare Primary Care in Virginia Beach, VA

Tidewater Medical Care Pc is a medicare enrolled primary clinic (Family Medicine) in Virginia Beach, Virginia. The current practice location for Tidewater Medical Care Pc is 4608 Thoroughgood Drive, Virginia Beach, Virginia. For appointments, you can reach them via phone at (757) 965-9465. The mailing address for Tidewater Medical Care Pc is 4608 Thoroughgood Drive, Virginia Beach, Virginia and phone number is (757) 965-9465.

Tidewater Medical Care Pc is licensed to practice in Virginia (license number 0101058505). The clinic also participates in the medicare program and its NPI number is 1053558981. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (757) 965-9465.

Contact Information

Tidewater Medical Care Pc
4608 Thoroughgood Drive
Virginia Beach
VA 23455
(757) 965-9465
(757) 965-9491

Primary Care Clinic Profile

Full NameTidewater Medical Care Pc
SpecialityFamily Medicine
Location4608 Thoroughgood Drive, Virginia Beach, Virginia
Authorized Official Name and PositionMigdonia Montejo (OWNER/PRESIDENT)
Authorized Official Contact7579659465
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tidewater Medical Care Pc
4608 Thoroughgood Drive
Virginia Beach
VA 23455

Ph: (757) 965-9465
Tidewater Medical Care Pc
4608 Thoroughgood Drive
Virginia Beach
VA 23455

Ph: (757) 965-9465

NPI Details:

NPI Number1053558981
Provider Enumeration Date01/14/2009
Last Update Date02/03/2010

Medicare PECOS Information:

Medicare PECOS PAC ID9133271661
Medicare Enrollment IDO20090715000076

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Medical Identifiers

Medical identifiers for Tidewater Medical Care Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053558981NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 0101058505 (Virginia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Tidewater Medical Care Pc acts as a billing entity for following providers:
Provider NameJudi Griffin
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1275506123
PECOS PAC ID: 8022084185
Enrollment ID: I20040909000489

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Provider NameBaher Anwar Basta
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1538130257
PECOS PAC ID: 6305878372
Enrollment ID: I20050910000074

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Provider NameMigdonia Montejo
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1467459347
PECOS PAC ID: 2062593080
Enrollment ID: I20080116000376

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Provider NameTammy Jo Maloney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689617102
PECOS PAC ID: 0749345379
Enrollment ID: I20090216000368

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Provider NameJorge M Zarate
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962409193
PECOS PAC ID: 4486706918
Enrollment ID: I20090715000084

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Provider NameRobert C Cajes
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1073776027
PECOS PAC ID: 2264619212
Enrollment ID: I20110531000756

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› Verified 5 days ago


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