NPIMap

Organization Active NPI

Bayhealth Medical Center, Inc

Doing business as Bayhealth Cardiology, Sussex Campus

  • Cardiovascular Disease Physician
  • Milford, DE
National Provider Identifier
1063938439
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BAYHEALTH MEDICAL CENTER, INC
Doing business as
Bayhealth Cardiology, Sussex Campus
Practice address
100 Wellness Way
Milford, DE 19963-4364
Phone
(302) 430-5738
Fax
(302) 744-7181
NPI assigned
Aug 17, 2017
Last updated
Feb 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Michael J Tretina
Title
Sr. Vice President/Cfo
Phone
(302) 744-7162

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

100 Wellness Way
Milford, DE 19963-4364

Mailing address

640 S State St
Dover, DE 19901-3530
Phone (302) 430-5738

Other names 1

  • Bayhealth Cardiology, Sussex Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190501000077 DE Part B Supplier - Hospital Department(S) 1658364740 Receives reassigned benefits from 27 practitioners
Practice locations: Milford, DE

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bayhealth Hospital, Kent CampusDover, DE, CCN 080004 Hospital Operational/Managerial Control (100%) Jan 1, 1997
Bayhealth HospitalMilford, DE, CCN 080009 Hospital Operational/Managerial Control (100%) Jan 1, 1997
Pam Rehabilitation Hospital of DoverDover, DE, CCN 083027 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2022
Pam Health Rehabilitation Hospital of GeorgetownGeorgetown, DE, CCN 083028 Hospital 5% Or Greater Direct Ownership Interest (50%) Jan 1, 2022
Bayada Home Health Care at BayhealthDover, DE, CCN 087024 Home health agency 5% Or Greater Direct Ownership Interest (48%) Jun 26, 2017

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1063938439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-430-5738",
            "fax_number": "302-744-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634364",
            "telephone_number": "302-430-5738",
            "fax_number": "302-744-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYHEALTH MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "TRETINA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "302-744-7162"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayhealth Cardiology, Sussex Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.