Tidewater Physicians Multispecialty Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC

Practice address

860 Omni Blvd Ste 401
Newport News, VA 23606-4430

Phone

(757) 232-8764

NPI assigned

Jun 12, 2006

Last updated

Jun 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cecilia C Quintero

Title

Credentialing Coordinator

Phone

(757) 964-8739

Specialties & licenses 14

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tidewater Physicians Multispecialty Group PC

  • Durable Medical Equipment & Medical Supplies
  • VA Beach, VA
  • NPI 1568236859

  2860398526

  Same PAC ID
• Tidewater Physicians Multispecialty Group PC

  • Durable Medical Equipment & Medical Supplies
  • Newport News, VA
  • NPI 1598904294

  2860398526

  Same PAC ID
• Tidewater Physicians Multispecialty Group PC

  • Durable Medical Equipment & Medical Supplies
  • Williamsburg, VA
  • NPI 1851530851

  2860398526

  Same PAC ID

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Rai Care Centers of Denbigh, LLC

  dba Fresenius Medical Care Denbigh

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Newport News, VA
  • NPI 1265854640

  Member Of

  NPD member
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512

  Member Of

  NPD member

Locations (25 of 26)

Practitioners 431

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.

• Masood Ahmed, MD

  • Interventional Cardiology Physician
  • Newport News, VA
  • NPI 1093796310

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Omar Shayan Ahmed, M.D.

  • Rheumatology Physician
  • Newport News, VA
  • NPI 1811263411

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Joshua Alan Albert, DO

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1740809235
  Medicare reassignment Care Compare group NPD
• Jacob D Almeida, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Newport News, VA
  • NPI 1609039080
  Medicare reassignment Care Compare group NPD
• Ahmed Amini, DO

  • Nephrology Physician
  • Newport News, VA
  • NPI 1053528307
  Medicare reassignment Care Compare group NPD
• Sean Michael Amport, CRNA

  • Certified Registered Nurse Anesthetist
  • Hampton, VA
  • NPI 1639576028
  Medicare reassignment Care Compare group NPD
• Ugur Yilmaz Anatolian, M.D

  • Neurology Physician
  • Newport News, VA
  • NPI 1063641835
  Medicare reassignment Care Compare group NPD
• Ifeanyichukwu Jude Ani, M.D.

  • Urology Physician
  • Newport News, VA
  • NPI 1992967046
  Medicare reassignment Care Compare group NPD
• Dana Lynne Bachtell, MD

  • Family Medicine Physician
  • Hampton, VA
  • NPI 1376547737
  Medicare reassignment Care Compare group NPD
• Matthew V Backens, MD

  • Family Medicine Physician
  • VA Beach, VA
  • NPI 1972766996
  Medicare reassignment Care Compare group NPD
• Matthew Gene Balderston, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1316386394
  Medicare reassignment Care Compare group NPD
• Scott J. Banning, M.D.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1487659801
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1902848294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 128",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064483",
            "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": "860 OMNI BLVD STE 401",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "QUINTERO",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "757-964-8739"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "182340975",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "223741512",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "229641543",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103300835",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA6708",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tidewater Physical Therapy, LLC
• Tidewater Physical Therapy, LLC
• Tidewater Physical Therapy, LLC
• Tidewater Physicians Multispecialty Group PC
• Tidewater Physicians Multispecialty Group PC
• Lauren Elizabeth Tidwell, CRNA
• Anita Rosemary Tieman, LPC
• Carolyn Foster Tighe, ED.D,LMFT,LPC
• Tiffany Tillery
• Darla L Timberlake, LPC

• Family Medicine Physician in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.