NPIMap

Individual provider Active NPI

Yury Kalmanovich, MD

  • Nephrology Physician
  • Norfolk, VA
National Provider Identifier
1992796767
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101230754 Issued in VA
Practice address
301 Riverview Ave Ste 512
Norfolk, VA 23510-1066
Phone
(757) 623-0005
Fax
(757) 389-5774
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0101230754 VA Primary

Addresses

Primary practice location

301 Riverview Ave Ste 512
Norfolk, VA 23510-1066

Mailing address

4445 Corporation LN Ste 100
Virginia Beach, VA 23462-3666
Phone (757) 623-0005

Other identifiers 3

IdentifierTypeStateIssuer
105577OtherVABCBS OF VA
541371648OtherVATAX ID
010054419MedicaidVA

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
I20110307000190 VA Practitioner - NephrologyPractitioner - Internal Medicine 5496937872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Kidney Specialists IncGroup PAC ID 6507852662, 21 clinicians

Practice addresses (Care Compare)

500 W 21St St
Suite 102
Norfolk, VA 23517-1955
Phone (757) 623-0005

Hospital & facility affiliations

  • DaVita Midtowne Norfolk Dialysis Dialysis facility, Norfolk, VA, CCN 492658
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Kidney Specialists, Inc. Nephrology CurrentSince Nov 1, 2003 Accepting new patients
Tidewater Kidney Specialists, Inc. Nephrology CurrentSince Nov 1, 2003 Accepting new patients

Locations

500 W 21st St
Ste 102
Norfolk, VA 23517

301 Riverview Ave
Ste 512
Norfolk, VA 23510
Phone (757) 627-5116

814 Kempsville Rd
Ste 102
Norfolk, VA 23502

4560 South Blvd
Ste 202
Virginia Beach, VA 23452
Phone (757) 340-6100

4445 Corporation Ln
Ste 100
Virginia Beach, VA 23462

Interoperability endpoints

  • Direct secure messaging: yurykalmanovich@tks.allscriptsdirect.net

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 9

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1992796767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623666",
            "telephone_number": "757-623-0005",
            "fax_number": "757-548-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 512",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101066",
            "telephone_number": "757-623-0005",
            "fax_number": "757-389-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALMANOVICH",
        "first_name": "YURY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101230754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF VA",
            "identifier": "105577",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "541371648",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010054419",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.