Individual provider Active NPI

Tonja Marie Devolgado, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1003455122
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024177680 Issued in VA
Practice address
2075 Glenn Mitchell Dr Ste 512
Virginia Beach, VA 23456-0179
Phone
(757) 507-8850
NPI assigned
Jan 6, 2020
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024177680 VA
Acute Care Nurse Practitioner 363LA2100X 0024177680 VA Primary
Adult Health Nurse Practitioner 363LA2200X 0024177680 VA
Gerontology Nurse Practitioner 363LG0600X 0024177680 VA

Addresses

Primary practice location

2075 Glenn Mitchell Dr Ste 512
Virginia Beach, VA 23456-0179

Mailing address

3913 Quartz LN
Virginia Beach, VA 23456-5860
Phone (757) 286-9864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409003348 VA Practitioner - Nurse Practitioner 6204265309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1080 1St Colonial Rd
200A
Virginia Beach, VA 23454-2406
Phone (757) 395-6070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Apr 20, 2020 Accepting new patients
Sentara Medical Group PastSince Apr 20, 2020 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1080 First Colonial Rd
Ste 200
Virginia Beach, VA 23454
Phone (757) 395-6070

1080 First Colonial Rd
Ste 200A
Virginia Beach, VA 23454
Phone (757) 395-6070

2075 Glenn Mitchell Dr
Ste 512
Virginia Beach, VA 23456
Phone (757) 507-8850

Interoperability endpoints

  • Direct secure messaging: tdeevolgado58154@direct.sentara.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1003455122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 QUARTZ LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234565860",
            "telephone_number": "757-286-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 GLENN MITCHELL DR STE 512",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560179",
            "telephone_number": "757-507-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOLGADO",
        "first_name": "TONJA",
        "middle_name": "MARIE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024177680",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024177680",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024177680",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024177680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.