Individual provider Active NPI

Reymond Damasco Pascual, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Hampton, VA
National Provider Identifier
1457520090
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
0101252195 Issued in VA
Practice address
6 Manhattan SQ Ste 100
Hampton, VA 23666-5846
Phone
(757) 826-2102
Fax
(757) 825-9482
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.054202 IL
Family Medicine Physician 207Q00000X MD443593 PA
Addiction Medicine (Family Medicine) Physician 207QA0401X 0101252195 VA Primary

Addresses

Primary practice location

6 Manhattan SQ Ste 100
Hampton, VA 23666-5846

Mailing address

860 Omni Blvd Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

Other practice location 1

2100 Hartford Rd
Hampton, VA 23666-2409
Phone (757) 826-2102

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
I20120912000069 VA Practitioner - Family Practice 7012170764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

6 Manhattan SQ
Suite 100
Hampton, VA 23666-5846
Phone (757) 826-2102

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

  • Amedisys Home Health of Newport News Home health agency, Hampton, VA, CCN 497091
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue269
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.054202ILMDFamily Medicine Physician
0101252195VAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Nov 1, 2014 Accepting new patients
Tidewater Physicians Multispecialty Group PC Family Medicine CurrentSince Nov 1, 2014 Accepting new patients

Locations

2100 Hartford Rd
Hampton, VA 23666
Phone (757) 826-2102

6 Manhattan Sq
Ste 100
Hampton, VA 23666
Phone (757) 826-2102

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

827 Diligence Dr
Ste 100
Newport News, VA 23606

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1457520090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MANHATTAN SQ STE 100",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665846",
            "telephone_number": "757-826-2102",
            "fax_number": "757-825-9482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236662409",
            "country_code": "US",
            "telephone_number": "757-826-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "REYMOND",
        "middle_name": "DAMASCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.054202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD443593",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "VA",
            "license": "0101252195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.