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TIDEWATER KIDNEY SPECIALISTS, INC.
NPI 1780624627
Internal Medicine - Nephrology in Virginia Beach, VA

Active since June 08, 2006
4445 CORPORATION LN STE 100, VIRGINIA BEACH, VA 23462(757) 623-0005(757) 548-1129 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 20, 2022, Feb 13, 2019, Sep 22, 2016 (3 updates tracked since 2016).

About Tidewater Kidney Specialists, Inc. NPPES

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

TIDEWATER KIDNEY SPECIALISTS, INC. (NPI 1780624627) is a healthcare organization registered as a nephrology in Virginia Beach, Virginia and active in the NPI registry since June 2006. The organization lists Elizabeth Skidmore, Administrator, as its authorized official.

NPPES Registry Identity

NPI1780624627
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameTIDEWATER KIDNEY SPECIALISTS, INC.
Location Address4445 CORPORATION LN STE 100Virginia Beach, VA 23462-3666
Mailing Address4445 Corporation Ln Ste 100Virginia Beach, VA 23462-3666 · (757) 623-0005 · Fax (757) 548-1129
Phone(757) 623-0005
Fax(757) 548-1129
Organization SubpartNo
Authorized OfficialElizabeth SkidmoreAdministrator · (757) 623-0005
Enumeration DateJune 8, 2006
Last NPPES UpdateJanuary 20, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2022
✔ NPI 1780624627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedSpecialistTaxonomy 174400000X
4445 CORPORATION LN STE 100, Virginia Beach, VA 23462
Open in Google Maps ↗

Other Identifiers 1

Medicaid890129JNC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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 Kidney Specialists, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

21

Medicare enrollment records show 21 clinicians reassign Medicare billing to Tidewater Kidney Specialists, Inc., which bills Medicare for the services they deliver. Of these, 12 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Nephrology19
Nurse Practitioner2

Nearest to this location (20)

See all 21
Madhu Kolli, MD
Nephrology
NPI 1114900552
828 HEALTHY WAY STE 270
Virginia Beach, VA 23462
(757) 623-0005
✔ PECOS✔ Accepts Medicare2.6 mi
Anitha Murthy, MD
Nephrology
NPI 1346204021
828 HEALTHY WAY STE 270
Virginia Beach, VA 23462
(757) 623-0005
✔ PECOS✔ Accepts Medicare2.6 mi
Melody Siff, MD
Nephrology
NPI 1205330750
814 KEMPSVILLE RD STE 102
Norfolk, VA 23502
(757) 623-0005
✔ PECOS✔ Accepts Medicare3.6 mi
Wei Zhao, M.D.
Nephrology
NPI 1205834405
814 KEMPSVILLE RD SUITE 102 BLDG 17
Norfolk, VA 23502
(757) 623-0005
✔ PECOS✔ Accepts Medicare3.6 mi
Angela Garcia, NP
Nurse Practitioner
NPI 1144656133
1200 FIRST COLONIAL RD SUITE 202
Virginia Beach, VA 23454
(757) 623-0005
✔ PECOS✔ Accepts Medicare5.5 mi
Melbeth Lusica, MD
Nephrology
NPI 1144487364
1200 FIRST COLONIAL RD STE 202
Virginia Beach, VA 23454
(757) 623-0005
✔ PECOS✔ Accepts Medicare5.5 mi
Haidr Agha, M.D.
Nephrology
NPI 1003048117
1157 FIRST COLONIAL RD STE 200
Virginia Beach, VA 23454
(757) 623-0005
✔ PECOS✔ Accepts Medicare5.5 mi
Dawn Bethea, ARNP
Nurse Practitioner
NPI 1346542800
300 MEDICAL PKWY STE 110
Chesapeake, VA 23320
(757) 623-0005
✔ PECOS✔ Accepts Medicare9.8 mi
Liwei Huang, MD
Nephrology
NPI 1912174939
300 MEDICAL PKWY SUITE 110
Chesapeake, VA 23320
(757) 623-0005
✔ PECOS✔ Accepts Medicare9.8 mi
Steven Lewinski, M.D.
Nephrology
NPI 1992788244
300 MEDICAL PKWY SUITE 110
Chesapeake, VA 23320
(757) 623-0005
✔ PECOS✔ Accepts Medicare9.8 mi
Daniel Rakowski, MD
Nephrology
NPI 1275504029
300 MEDICAL PKWY SUITE 110
Chesapeake, VA 23320
(757) 623-0005
✔ PECOS✔ Accepts Medicare9.8 mi
Sam Gao, MD
Nephrology
NPI 1831181650
NAVAL MEDICAL CENTER PORTSMOUTH 620 JOHN PAUL JONES CIRCLE
Portsmouth, VA 23708
(757) 953-2051
✔ PECOS✔ Accepts Medicare9.9 mi
Malik Anjum, M.D.
Nephrology
NPI 1386902104
301 RIVERVIEW AVE STE 512
Norfolk, VA 23510
(757) 623-0005
✔ PECOS✔ Accepts Medicare10 mi
Kiranjit Dhillon, MD
Nephrology
NPI 1598722803
301 RIVERVIEW AVE STE 512
Norfolk, VA 23510
(757) 623-0005
✔ PECOS✔ Accepts Medicare10 mi
Yury Kalmanovich, MD
Nephrology
NPI 1992796767
301 RIVERVIEW AVE STE 512
Norfolk, VA 23510
(757) 623-0005
✔ PECOS✔ Accepts Medicare10 mi
Bhupinder Prajapati, MBBS, MD
Nephrology
NPI 1871932459
301 RIVERVIEW AVE STE 512
Norfolk, VA 23510
(757) 623-0005
✔ PECOS✔ Accepts Medicare10 mi
Hooman Sadr, MD
Nephrology
NPI 1598833188
301 RIVERVIEW AVE STE 512
Norfolk, VA 23510
(757) 623-0005
✔ PECOS✔ Accepts Medicare10 mi
Daniel Dean, D.O.
Nephrology
NPI 1922329754
620 JOHN PAUL JONES CIRCLE NAVAL MEDICAL CENTER NEPHROLOGY CLINIC
Portsmouth, VA 23708
(757) 953-2051
✔ PECOS✔ Accepts Medicare13 mi
Onweli Ogbolu, M.D.
Nephrology
NPI 1336301423
3009 CORPORATE LN STE 210
Suffolk, VA 23434
(757) 623-0005
✔ PECOS✔ Accepts Medicare26 mi
Alexander Gogoli, DO
Nephrology
NPI 1902435639
1871 EVELYN BYRD AVE
Harrisonburg, VA 22801
(540) 564-5800
✔ PECOS✔ Accepts Medicare185 mi
See all 21 clinicians

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 Kidney Specialists, Inc.'s NPI number?

The NPI number for Tidewater Kidney Specialists, Inc. is 1780624627. It was assigned to this organization in the NPPES registry on June 8, 2006.

Where is Tidewater Kidney Specialists, Inc. located?

Tidewater Kidney Specialists, Inc. is located at 4445 Corporation Ln Ste 100, Virginia Beach, VA 23462. The listed phone number is (757) 623-0005.

What is Tidewater Kidney Specialists, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Tidewater Kidney Specialists, Inc. enrolled in Medicare?

Yes. Tidewater Kidney Specialists, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidewater Kidney Specialists, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 2 Medicare specialties reassign their Medicare billing to Tidewater Kidney Specialists, Inc.. 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. The largest specialties are Nephrology (19) and Nurse Practitioner (2). Of these, 12 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tidewater Kidney Specialists, Inc. accept?

Health plans from Blue Cross and Blue Shield of NC list Tidewater Kidney Specialists, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tidewater Kidney Specialists, Inc. was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.