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RETINA GROUP OF TIDEWATER PC NPI 1629256441


NPI Information

NPI: 1629256441
Provider Name: RETINA GROUP OF TIDEWATER PC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
400 GRESHAM DR STE 308
NORFOLK, VA
ZIP 23507
Phone: (757) 622-7000
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RETINA GROUP OF TIDEWATER PC is an ophthalmology in Norfolk, VA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. RETINA GROUP OF TIDEWATER PC NPI is 1629256441. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

400 GRESHAM DR STE 308
NORFOLK, VA
ZIP 23507-901
Phone: (757) 622-7000
Fax: (757) 623-6708

The provider's authorized official is Venkat Manoranjan Reddy .
The authorized official title is Physician/owner and has the following contact phone number (757) 622-7000.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 12/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology0101051339VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F30105MEDICARE UPINVIRGINIA
26303251MEDICAIDVIRGINIA
3180024376MEDICARE PINVIRGINIA
4180000610MEDICARE PINVIRGINIA
5C04656MEDICARE PINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.