Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

John Robert Goodwin

Individual provider Physician Assistant · NPI 1053095653

John Robert Goodwin is a Physician Assistant in Virginia Beach, Virginia. Qualified in 2023, 3 years ago. Practices with Tidewater Physicians Multispecialty Group, PC, a 269-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
3
In the registry since
2023
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Practice location Address checks out

4421 Virginia Beach Blvd #112
Virginia Beach, VA 23462
Phone: (757) 963-1488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1053095653
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 14, 2023
Last updated in NPPESJune 14, 2023
Certification dateJune 13, 2023
Mailing address4 Gateshead Dr, Flemington, NJ 08822

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Tidewater Physicians Multispecialty Group, Pc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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