Organization Active NPI

Atlantic Internal Medicine

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1427657667
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ATLANTIC INTERNAL MEDICINE
Practice address
171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700
Phone
(757) 975-4695
Fax
(757) 852-0699
NPI assigned
Oct 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Ramon Matawaran, MDNPI 1467427773
Title
Sole Properitor
Phone
(757) 915-8691

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700

Mailing address

171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700
Phone (757) 975-4695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210204000330 VA Part B Supplier - Clinic/Group Practice 5991119836 Receives reassigned benefits from 1 practitioner
Practice locations: Norfolk, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2197849Atlantic Internal Medicine171 Kempsville Rd, Building a, Norfolk, VA 23502Certificate of waiverOct 27, 2026

National Provider Directory

National Provider Directory

Locations

1232 Perimeter Pkwy
Ste 205
Virginia Beach, VA 23454
Phone (757) 448-5451

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22675/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1427657667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD BLDG A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-975-4695",
            "fax_number": "757-852-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD BLDG A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-975-4695",
            "fax_number": "757-852-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "MATAWARAN",
        "authorized_official_first_name": "RAMON",
        "authorized_official_title_or_position": "SOLE PROPERITOR",
        "authorized_official_telephone_number": "757-915-8691",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "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 Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.