Individual provider Active NPI

Mark Anthony Penta, PA-C

  • Surgical Physician Assistant
  • Newark, DE
National Provider Identifier
1154456069
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C5-0000202 Issued in DE
Practice address
4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713-2067
Phone
(302) 731-2888
Fax
(302) 368-0103
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C5-0000202 DE Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713-2067

Mailing address

4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713-2067
Phone (302) 731-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000255 MD Practitioner - Physician Assistant 7416054036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

137 W High St
Union General Surgery and Urology Suite 2B
Elkton, MD 21921-8615
Phone (410) 620-2244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C5-0000202DEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Jul 31, 2018 Accepting new patients
Union Hospital of Cecil County CurrentSince Jul 31, 2018 Accepting new patients
Delmar Emergency Specialists PA Past Accepting new patients
First State Orthopaedics, PA Past Accepting new patients
Morgan Kalman Clinic PA Past Accepting new patients

Locations

210 Chesapeake Blvd
Elkton, MD 21921

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

137 W High St
Ste 2B
Elkton, MD 21921
Phone (410) 398-0451

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1154456069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 225",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132067",
            "telephone_number": "302-731-2888",
            "fax_number": "302-368-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 225",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132067",
            "telephone_number": "302-731-2888",
            "fax_number": "302-368-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTA",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C5-0000202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.