1. Home
  2. Directory
  3. Virginia
  4. Beach
  5. Family Medicine
  6. NPI Profile

TIDEWATER MEDICAL CARE PC
NPI 1053558981
Family Medicine in Virginia Beach, VA

Active since January 14, 2009
4608 THOROUGHGOOD DRIVE, VIRGINIA BEACH, VA 23455(757) 965-9465(757) 965-9491 Get Directions Write a Review

NPPES record last updated: February 3, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tidewater Medical Care Pc NPPES

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

TIDEWATER MEDICAL CARE PC (NPI 1053558981) is a healthcare organization registered as a family medicine in Virginia Beach, Virginia and active in the NPI registry since January 2009. The organization lists Migdonia Montejo, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1053558981
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTIDEWATER MEDICAL CARE PC
Location Address4608 THOROUGHGOOD DRIVEVirginia Beach, VA 23455
Mailing Address4608 Thoroughgood DriveVirginia Beach, VA 23455 · (757) 965-9465 · Fax (757) 965-9491
Phone(757) 965-9465
Fax(757) 965-9491
Organization SubpartNo
Authorized OfficialMigdonia MontejoOwner/president · (757) 965-9465
Enumeration DateJanuary 14, 2009
Last NPPES UpdateFebruary 3, 2010
✔ NPI 1053558981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101058505
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4608 THOROUGHGOOD DRIVE, Virginia Beach, VA 23455
Open in Google Maps ↗

Other Names 1

Doing Business AsTidewater Medical Care Pc

Other Identifiers 12

Medicare PIN022225T53VA
Medicare PIN00Y060T03VA
Medicare PIN00Y060T02VA
Medicare UPING74678VA
Medicare UPING90778VA
Medicare PIN020744T53VA
Medicare PIN022057T53VA
Medicare PIN00Y060T01VA
Medicare PIN020738T53VA
Medicare PIN021208T58VA
Medicare PIN021663T53VA
Medicare PINC10753VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tidewater Medical Care Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Tidewater Medical Care PC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Judi Griffin, MD
Hospitalist
NPI 1275506123
816 INDEPENDENCE BLVD SUITE 1H
Virginia Beach, VA 23455
(757) 464-2013
✔ PECOS✔ Accepts Medicare1.9 mi
Jorge Zarate, M.D.
Family Practice
NPI 1962409193
830 KEMPSVILLE RD
Norfolk, VA 23502
(757) 967-8622
✔ PECOS✔ Accepts Medicare4.6 mi
Brandy D'antonio, FNP
Nurse Practitioner
NPI 1417026907
110 KINGSLEY LN SUITE 106
Norfolk, VA 23505
(757) 889-5735
✔ PECOS✔ Accepts Medicare8.4 mi
Migdonia Montejo, M.D.
Family Practice
NPI 1467459347
110 KINGSLEY LN SUITE 106
Norfolk, VA 23505
(757) 889-5735
✔ PECOS✔ Accepts Medicare8.4 mi
Tammy Maloney, F.N.P.
Nurse Practitioner
NPI 1689617102
600 GRESHAM DR STE 8630B
Norfolk, VA 23507
(757) 388-6115
✔ PECOS✔ Accepts Medicare9.9 mi
Lisa Lawson, M.D.
Hospitalist
NPI 1902960503
600 GRESHAM DR
Norfolk, VA 23507
(757) 446-8920
✔ PECOS✔ Accepts Medicare9.9 mi
Baher Basta, MD
Nephrology
NPI 1538130257
3800 POPLAR HILL RD STE A
Chesapeake, VA 23321
(757) 499-6978
✔ PECOS✔ Accepts Medicare15 mi

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

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 Tidewater Medical Care PC's NPI number?

The NPI number for Tidewater Medical Care PC is 1053558981. It was assigned to this organization in the NPPES registry on January 14, 2009.

Where is Tidewater Medical Care PC located?

Tidewater Medical Care PC is located at 4608 Thoroughgood Drive, Virginia Beach, VA 23455. The listed phone number is (757) 965-9465.

What is Tidewater Medical Care PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tidewater Medical Care PC enrolled in Medicare?

Yes. Tidewater Medical Care PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidewater Medical Care PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians reassign their Medicare billing to Tidewater Medical Care PC, in Family Practice, Hospitalist, Nephrology and Nurse Practitioner. A 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 the clinician's services. Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tidewater Medical Care PC was last updated on February 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.