NPIMap

Organization Active NPI

Premier Medical Associates

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1154836500
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PREMIER MEDICAL ASSOCIATES
Practice address
620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134
Phone
(302) 449-7484
Fax
(302) 327-4203
NPI assigned
Dec 7, 2017
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Lyron Andre DeputyNPI 1134441702
Title
Owner
Phone
(302) 652-5109

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134

Mailing address

620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134
Phone (302) 449-7484

Other practice location 1

1400 Philadelphia Pike Ste A4
Wilmington, DE 19809-1856
Phone (302) 375-6746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200619000031 DE Part B Supplier - Clinic/Group Practice 0345662490 Receives reassigned benefits from 14 practitioners
11 other NPIs on this enrollment
Practice locations: Wilmington, DE; Newark, DE; Millsboro, DE; Milford, DE; Middletown, DE; Lewes, DE; Georgetown, DE; Dover, DE

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Premier Medical Associates11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1893 S DuPont Hwy
Ste 101
Dover, DE 19901

1408 Savannah Rd
Lewes, DE 19958
Phone (302) 430-2127

212 Carter Dr
Ste E
Middletown, DE 19709
Phone (302) 482-2035

118 Sandhill Dr
Ste 2
Middletown, DE 19709

1400 Philadelphia Pike
Ste A4
Wilmington, DE 19809
Phone (302) 472-4878

700 W Lea Blvd
Wilmington, DE 19802
Phone (302) 320-4050

700 W Lea Blvd
Ste 301
Wilmington, DE 19802
Phone (302) 764-2072

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1154836500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 STANTON CHRISTIANA RD STE 101",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132134",
            "telephone_number": "302-449-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 STANTON CHRISTIANA RD STE 101",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132134",
            "telephone_number": "302-449-7484",
            "fax_number": "302-327-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Philadelphia Pike Ste A4",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198091856",
            "country_code": "US",
            "telephone_number": "302-375-6746",
            "fax_number": "302-375-6822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "DEPUTY",
        "authorized_official_first_name": "LYRON",
        "authorized_official_middle_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-652-5109"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.