TIDEWATER FOOT CENTER LLC
NPI 1891137048
Podiatrist - Foot Surgery in Newport News, VA
About Tidewater Foot Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIDEWATER FOOT CENTER LLC (NPI 1891137048) is a healthcare organization registered as a foot surgery in Newport News, Virginia and active in the NPI registry since July 2013. The organization lists Steven Thou Prak, Sole Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Foot Center Llc 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 Tidewater Foot Center LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Foot Center LLC's NPI number?
The NPI number for Tidewater Foot Center LLC is 1891137048. It was assigned to this organization in the NPPES registry on July 29, 2013.
Where is Tidewater Foot Center LLC located?
Tidewater Foot Center LLC is located at 126 Monarch Dr, Newport News, VA 23602. The listed phone number is (757) 597-1520.
What is Tidewater Foot Center LLC's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot Surgery, with taxonomy code 213ES0131X.
Is Tidewater Foot Center LLC enrolled in Medicare?
Yes. Tidewater Foot Center LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tidewater Foot Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Tidewater Foot Center LLC. 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 Tidewater Foot Center LLC was last updated on December 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Tidewater Foot Center Llc · NPI 1891137048
Foot Surgery organization in Newport News, Virginia. Organization record, active in the CMS NPPES registry since July 29, 2013.
## Identity
- **NPI:** 1891137048 (Entity type: Organization)
- **Enumerated:** July 29, 2013
- **Primary specialty:** Podiatrist - Foot Surgery · taxonomy 213ES0131X
- **Organization subpart:** No
- **Authorized official:** Steven Prak, SOLE OWNER
## Practice location
- **Address:** 126 MONARCH DR, Newport News, VA 23602-6884
- **Phone:** (757) 597-1520 · **Fax:** (757) 597-7099
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 9, 2013
---
Source: [NPI Profile](https://npiprofile.com/npi/1891137048) · Data from the CMS NPPES public registry.