Individual provider Active NPI

Theodore Tzavaras

  • Emergency Medicine Physician
  • Norfolk, VA
National Provider Identifier
1093109001
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101264359 Issued in VA
Practice address
600 Gresham Dr
Suite 304
Norfolk, VA 23507
Phone
(757) 388-3397
NPI assigned
Mar 27, 2015
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101264359 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Suite 304
Norfolk, VA 23507

Mailing address

600 Gresham Dr
Suite 304
Norfolk, VA 23507-1904
Phone (757) 388-3397

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180905000251 VA Practitioner - Emergency Medicine 8527378330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Eastern Virginia Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

3920 Bridge Rd
Suffolk, VA 23435-1107
Phone (757) 686-3508

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101264359VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Tidewater Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Observation Physicians of Tidewater CurrentSince Aug 1, 2022 Accepting new patients
Emergency Physicians of Tidewater, PC Emergency Medicine Current Accepting new patients
Sentara Medical Group Emergency Medicine Past Accepting new patients

Locations

600 Gresham Dr
Ste 304
Norfolk, VA 23507
Phone (757) 388-3397

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 934-4000

3920 Bridge Rd
Suffolk, VA 23435
Phone (757) 983-0000

Organizations & group practices 4

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1093109001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "address_2": "SUITE 304",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "address_2": "SUITE 304",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23507",
            "telephone_number": "757-388-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TZAVARAS",
        "first_name": "THEODORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101264359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.