Individual provider Active NPI

Antonio Quidgley-Nevares, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Norfolk, VA
National Provider Identifier
1467428375
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0101231877 Issued in VA
Practice address
721 Fairfax Ave
3Rd Floor
Norfolk, VA 23507-2007
Phone
(757) 446-5915
Fax
(757) 446-5969
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0101231877 VA Primary

Addresses

Primary practice location

721 Fairfax Ave
3Rd Floor
Norfolk, VA 23507-2007

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5915

Other identifiers 16

IdentifierTypeStateIssuer
-017OtherVATRICARE/CHAMPUS
010065801MedicaidVA
06678OtherNCBC/BS
10007083OtherVASENTARA/OPTIMA
139142OtherVAANTHEM
PAROtherVACIGNA
PAROtherVAAETNA
PAROtherVAMULTIPLAN
PAROtherVAUSA MANAGED CARE
PAROtherVAFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
8906678MedicaidNC
76226OtherVASENTARA
PAROtherVACORVEL/CORCARE
PAROtherVAVIRGINIA PREMIER HEALTH
PAROtherVAVIRGINIA HEALTH NETWORK
3117723OtherVAUHC/MAMSI

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
I20040427001546 VA Practitioner - Physical Medicine and Rehabilitation 6800883331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Puerto Rico School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Invictus Health LLCGroup PAC ID 6608107792, 2 clinicians

Practice addresses (Care Compare)

1030 Loftis Blvd
Suite 201
Newport News, VA 23606-2999
Phone (757) 310-6413

721 Fairfax Ave
Norfolk, VA 23507-2007
Phone (757) 446-5915

Hospital & facility affiliations

  • @Heart Hospice Hospice, Virginia Beach, VA, CCN 491625
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Invictus Health LLC CurrentSince Jan 1, 2023 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation CurrentSince Jul 19, 2004 Accepting new patients
Childrens Specialty Group PLLC Past Accepting new patients
JP Therapy, LLC PastSince Jan 1, 2023 Accepting new patients

Locations

1030 Loftis Blvd
Ste 201
Newport News, VA 23606
Phone (757) 310-6413

721 Fairfax Ave
Fl 3
Norfolk, VA 23507
Phone (757) 446-5915

721 Fairfax Ave
Norfolk, VA 23507
Phone (757) 446-5955

825 Fairfax Ave
Ste 445
Norfolk, VA 23507
Phone (757) 446-5758

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFACCD
  • Direct secure messaging: antonio.quidgley-nevares.1@31849.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1467428375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5915",
            "fax_number": "757-446-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAIRFAX AVE",
            "address_2": "3RD FLOOR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235072007",
            "telephone_number": "757-446-5915",
            "fax_number": "757-446-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIDGLEY-NEVARES",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101231877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-017",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010065801",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "06678",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "10007083",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "139142",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8906678",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "76226",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORCARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/MAMSI",
            "identifier": "3117723",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.