NPIMap

Organization Active NPI

Observation Physicians of Tidewater

  • Hospitalist Physician
  • Norfolk, VA
National Provider Identifier
1306590450
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
OBSERVATION PHYSICIANS OF TIDEWATER
Practice address
830 Kempsville Rd
Norfolk, VA 23502-3920
Phone
(757) 261-6000
NPI assigned
Feb 8, 2022
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
EMERGENCY PHYSICIANS OF TIDEWATERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Theodore Tzavaras, MDNPI 1093109001
Title
Ao
Phone
(757) 467-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

830 Kempsville Rd
Norfolk, VA 23502-3920

Mailing address

6379 Center Dr
Norfolk, VA 23502-4102
Phone (757) 467-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220819000428 VA Part B Supplier - Clinic/Group Practice 8123401429 Receives reassigned benefits from 78 practitioners
Practice locations: Suffolk, VA; Norfolk, VA

National Provider Directory

National Provider Directory
Part of
Emergency Physicians Ti

Locations

6379 Center Dr
Norfolk, VA 23502
Phone (757) 467-4200

Practitioners & affiliated clinicians

Practitioners 79

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1306590450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6379 CENTER DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024102",
            "telephone_number": "757-467-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 KEMPSVILLE RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023920",
            "telephone_number": "757-261-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSERVATION PHYSICIANS OF TIDEWATER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMERGENCY PHYSICIANS OF TIDEWATER",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "TZAVARAS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "757-467-4200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.