Individual provider Active NPI

Emmanuel Devotta, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Wilmington, DE
National Provider Identifier
1083761258
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
C10002119 Issued in DE
Practice address
4512 Kirkwood Hwy
Suite 200
Wilmington, DE 19808-5123
Phone
(302) 998-2585
Fax
(302) 998-3394
NPI assigned
Jan 3, 2007
Last updated
Apr 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X C10002119 DE Primary

Addresses

Primary practice location

4512 Kirkwood Hwy
Suite 200
Wilmington, DE 19808-5123

Mailing address

4512 Kirkwood Hwy
Suite 200
Wilmington, DE 19808-5123
Phone (302) 998-2585

Other identifiers 3

IdentifierTypeStateIssuer
050086512OtherRAIL ROAD MEDICARE
0100002000OtherAMERIHEALTH
0000115501MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1083761258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085123",
            "telephone_number": "302-998-2585",
            "fax_number": "302-998-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085123",
            "telephone_number": "302-998-2585",
            "fax_number": "302-998-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOTTA",
        "first_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "DE",
            "license": "C10002119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "050086512",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0100002000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000115501",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.