Individual provider Active NPI

Charmaine Guballa Silva-Gata, M.D

  • Psychiatry Physician
  • Virginia Beach, VA
National Provider Identifier
1124317391
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101257965 Issued in VA
Practice address
1020 First Colonial Rd Ste a
Virginia Beach, VA 23454-3002
Phone
(757) 395-1850
Fax
(757) 961-5622
NPI assigned
Mar 28, 2011
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 0101257965 VA Primary

Addresses

Primary practice location

1020 First Colonial Rd Ste a
Virginia Beach, VA 23454-3002

Mailing address

825 Fairfax Ave Ste 710
Norfolk, VA 23507-1914
Phone (757) 446-5884

Other practice location 1

825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914
Phone (757) 446-5884

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
I20190530000560 VA Practitioner - Psychiatry 7719220060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
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
Suite 403
Virginia Beach, VA 23454-2406
Phone (757) 395-1850

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Single Specialty CurrentSince Jun 1, 2019 Accepting new patients
Sentara Hospitals Past Accepting new patients

Locations

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

1020 First Colonial Rd
Ste A
Virginia Beach, VA 23454
Phone (757) 395-5342

1080 First Colonial Rd
Ste 403
Virginia Beach, VA 23454
Phone (757) 496-6537

Interoperability endpoints

  • Direct secure messaging: csilvagata496902@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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1124317391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 710",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5884",
            "fax_number": "757-446-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FIRST COLONIAL RD STE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543002",
            "telephone_number": "757-395-1850",
            "fax_number": "757-961-5622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Fairfax Ave",
            "address_2": "Suite 710",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071914",
            "country_code": "US",
            "telephone_number": "757-446-5884",
            "fax_number": "757-446-5918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILVA-GATA",
        "first_name": "CHARMAINE",
        "middle_name": "GUBALLA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101257965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.