NPIMap

Individual provider Active NPI

Basavalinga Swamy Talur Matadha, MD

  • Hospitalist Physician
  • Portsmouth, VA
National Provider Identifier
1639378839
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0101245352 Issued in VA
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(757) 398-2280
NPI assigned
Jul 17, 2007
Last updated
Dec 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101245352 VA Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090619000528 VA Practitioner - Internal Medicine 9739230491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians

Practice addresses (Care Compare)

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101245352VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Roanoke Valley Healthcare Partners, LLC CurrentSince Jan 6, 2024 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Southeastern Physician Services PC Hospitalist Past Accepting new patients
Short Pump Family Care, LLC PastSince Feb 1, 2016 Accepting new patients
Blue Ridge Healthcare Partners, LLC Past Accepting new patients

Locations

9276 Old Keene Mill Rd
Burke, VA 22015
Phone (571) 516-3116

12731 Stone Village Way
Midlothian, VA 23113
Phone (804) 379-1500

1119 N Military Hwy
Ste 300
Norfolk, VA 23502
Phone (757) 224-3004

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

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

602 Brandon Ave SW
Ste 222
Roanoke, VA 24015
Phone (540) 774-0000

1013 University Blvd
Ste 270
Suffolk, VA 23435
Phone (757) 335-4755

14087 Richmond Hwy
Ste 101
Woodbridge, VA 22191
Phone (571) 300-8000

4101 Cheshire Station Plz
Ste 500
Woodbridge, VA 22193
Phone (571) 374-1234

Organizations & group practices 6

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 11

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1639378839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALUR MATADHA",
        "first_name": "BASAVALINGA",
        "middle_name": "SWAMY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101245352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.