NPIMap

Organization Active NPI

First State Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Middletown, DE
National Provider Identifier
1043918824
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
FIRST STATE ORTHOPAEDICS PA
Practice address
601 Tower LN Ste 201
Middletown, DE 19709-1763
Phone
(302) 731-2888
NPI assigned
Feb 21, 2023
Last updated
Feb 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
David Blaeuer
Title
Executive Director
Phone
(302) 731-2888

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU
Podiatrist 213E00000X NU

Addresses

Primary practice location

601 Tower LN Ste 201
Middletown, DE 19709-1763

Mailing address

211 Executive Dr Ste 11
Newark, DE 19702-3358
Phone (302) 731-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107001568 DE DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - Podiatry 6103800057 Practice locations: Middletown, DE

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

601 Tower Ln
Ste 201
Middletown, DE 19709

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1043918824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EXECUTIVE DR STE 11",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023358",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TOWER LN STE 201",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091763",
            "telephone_number": "302-731-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST STATE ORTHOPAEDICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "BLAEUER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "302-731-2888"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.