Delaware Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C10005294 Issued in DE

Legal business name

DELAWARE PRIMARY CARE LLC

Practice address

810 New Burton Rd
Suite 3
Dover, DE 19904-5451

Phone

(302) 730-0554

Fax

(302) 730-1175

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Alisha T Patrickcooks

Title

Billing Department

Phone

(302) 730-0554

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Louis Joseph-Romel Crevecoeur, MD

  • Internal Medicine Physician
  • Seaford, DE
  • NPI 1609127893

  DE, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lisa Leonard, MSN, FNP-C

  • Family Nurse Practitioner
  • Dover, DE
  • NPI 1861871238

  DE

  Medicare reassignment Care Compare group NPD
• Sandeep Mann, M.D.

  • Internal Medicine Physician
  • Dover, DE
  • NPI 1891776761

  DE, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Abimbola Osunyele Osunkoya, M.D, M.R., C.O.G.

  • Internal Medicine Physician
  • Dover, DE
  • NPI 1285615146

  DE, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hardi Patel

  • Primary Care Nurse Practitioner
  • Dover, DE
  • NPI 1558972398

  DE, Single Specialty

  Medicare reassignment Care Compare group NPD
• Theodore Conrad Ang Tan, M.D.

  • Internal Medicine Physician
  • Dover, DE
  • NPI 1003046624

  DE, Internal Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1104852300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 NEW BURTON RD",
            "address_2": "SUITE 3",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045451",
            "telephone_number": "302-730-0554",
            "fax_number": "302-730-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NEW BURTON RD",
            "address_2": "SUITE 3",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045451",
            "telephone_number": "302-730-0554",
            "fax_number": "302-730-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "PATRICKCOOKS",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "BILLING DEPARTMENT",
        "authorized_official_telephone_number": "302-730-0554"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005391",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CK3544",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001165602",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delaware Open MRI Radiology Associates
• Delaware Orthopaedics and Sports Medicine
• Delaware Physiatry
• Delaware Plastic Surgery PA
• Delaware Podiatric Medicine PA
• Delaware Radiation Associates, PA
• Delaware Sleep Disorder Centers
• Delaware Sleep Disorder Centers, LLC
• Delaware Surgery Center, LLC
• Tylira Deleon

• All providers in Dover, DE
• Internal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.