| Centerwell Senior Primary Care Va Pllc | |
|
7525 Tidewater Dr Ste 19 Norfolk VA 23505-3700 | |
| (757) 330-0150 | |
| (877) 487-3044 |
| Full Name | Centerwell Senior Primary Care Va Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7525 Tidewater Dr Ste 19, Norfolk, Virginia |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care Va Pllc 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care Va Pllc 7525 Tidewater Dr Ste 19 Norfolk VA 23505-3700 Ph: (757) 330-0150 |
| NPI Number | 1568162808 |
|---|---|
| Provider Enumeration Date | 03/06/2023 |
| Last Update Date | 08/19/2024 |
| Medicare PECOS PAC ID | 8426414186 |
|---|---|
| Medicare Enrollment ID | O20230523000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568162808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Lisa R Cash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487635181 PECOS PAC ID: 1850290396 Enrollment ID: I20040105000399 |
| Provider Name | Abraham Teklu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285773101 PECOS PAC ID: 4880668219 Enrollment ID: I20040823000556 |
| Provider Name | Chinmayee D Banerji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972567675 PECOS PAC ID: 5991728586 Enrollment ID: I20060110000472 |
| Provider Name | Rumki C Banerjee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871702712 PECOS PAC ID: 1850487661 Enrollment ID: I20071009000935 |
| Provider Name | Anthony J Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902922305 PECOS PAC ID: 4082763941 Enrollment ID: I20090522000473 |
| Provider Name | Sheila Turbides Minaya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841506375 PECOS PAC ID: 3779725015 Enrollment ID: I20130815000472 |
| Provider Name | Nidjan Aquino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760825202 PECOS PAC ID: 8224252051 Enrollment ID: I20160425001382 |
| Provider Name | Darlene Frances Proctor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659506954 PECOS PAC ID: 1254616147 Enrollment ID: I20170327001916 |
| Provider Name | Kristine J Salvador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043732472 PECOS PAC ID: 5799051447 Enrollment ID: I20171024002274 |
| Provider Name | Amabelle Picardo Florendo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790272441 PECOS PAC ID: 6305195579 Enrollment ID: I20190410001917 |
| Provider Name | Kirstin H Negron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558853937 PECOS PAC ID: 2062817869 Enrollment ID: I20210817001880 |
| Provider Name | Jacqueline Adkins-harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316618051 PECOS PAC ID: 8921496977 Enrollment ID: I20220730000278 |
| Provider Name | Erica Lache' Savage-jeter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275657694 PECOS PAC ID: 9739234584 Enrollment ID: I20230626000227 |
| Provider Name | Angelika Jovin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609982834 PECOS PAC ID: 5395743074 Enrollment ID: I20230809003641 |
| Provider Name | Jocelyn Alisa Sampson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427524958 PECOS PAC ID: 8921419557 Enrollment ID: I20231108003916 |
| Provider Name | Joan D West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972088508 PECOS PAC ID: 5597162834 Enrollment ID: I20240201004205 |
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