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RETINA GROUP OF TIDEWATER PC
NPI 1629256441
Ophthalmology in Norfolk, VA

Active since February 04, 2008
400 GRESHAM DR STE 308, NORFOLK, VA 23507(757) 622-7000(757) 623-6708 Get Directions Write a Review

NPPES record last updated: December 8, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Retina Group Of Tidewater Pc NPPES

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

RETINA GROUP OF TIDEWATER PC (NPI 1629256441) is a healthcare organization registered as an ophthalmology in Norfolk, Virginia and active in the NPI registry since February 2008. The organization lists Venkat Manoranjan Reddy, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1629256441
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameRETINA GROUP OF TIDEWATER PC
Location Address400 GRESHAM DR STE 308Norfolk, VA 23507-1901
Mailing Address400 Gresham Dr Ste 308Norfolk, VA 23507-1901 · (757) 622-7000 · Fax (757) 623-6708
Phone(757) 622-7000
Fax(757) 623-6708
Organization SubpartNo
Authorized OfficialVenkat Manoranjan ReddyPhysician/owner · (757) 622-7000
Enumeration DateFebruary 4, 2008
Last NPPES UpdateDecember 8, 2011
✔ NPI 1629256441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in VA · 0101051339
Definition
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.
400 GRESHAM DR STE 308, Norfolk, VA 23507
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Other Identifiers 5

Medicare UPINF30105VA
Medicaid6303251VA
Medicare PIN180024376VA
Medicare PIN180000610VA
Medicare PINC04656VA

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)

Retina Group Of Tidewater Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Retina Group Of Tidewater PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Venkat Reddy, M.D.
Ophthalmology
NPI 1437169042
4433 CORPORATION LN STE 195
Virginia Beach, VA 23462
(757) 622-7000
✔ PECOS✔ Accepts Medicare9.9 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 Retina Group Of Tidewater PC's NPI number?

The NPI number for Retina Group Of Tidewater PC is 1629256441. It was assigned to this organization in the NPPES registry on February 4, 2008.

Where is Retina Group Of Tidewater PC located?

Retina Group Of Tidewater PC is located at 400 Gresham Dr Ste 308, Norfolk, VA 23507. The listed phone number is (757) 622-7000.

What is Retina Group Of Tidewater PC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Retina Group Of Tidewater PC enrolled in Medicare?

Yes. Retina Group Of Tidewater PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Retina Group Of Tidewater PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Retina Group Of Tidewater PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Retina Group Of Tidewater PC was last updated on December 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.