Individual provider Active NPI

Ian Michael Lonergan, D.O.

  • Plastic and Reconstructive Surgery Physician
  • Wilmington, DE
National Provider Identifier
1174795744
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
C20008811 Issued in DE
Practice address
1600 Pennsylvania Ave
Wilmington, DE 19806-4047
Phone
(302) 656-0214
Fax
(877) 284-8933
NPI assigned
Mar 24, 2008
Last updated
Apr 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C20008811 DE
Plastic Surgery Physician 208200000X 5101017079 MI
Plastic and Reconstructive Surgery Physician 2086S0122X C20008811 DE Primary
General Practice Physician 208D00000X C20008811 DE

Addresses

Primary practice location

1600 Pennsylvania Ave
Wilmington, DE 19806-4047

Mailing address

1600 Pennsylvania Ave
Wilmington, DE 19806-4047
Phone (302) 656-0214

Other identifiers 1

IdentifierTypeStateIssuer
136323YABTOtherMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081105000358 DE Practitioner - Plastic and Reconstructive SurgeryPractitioner - General PracticePractitioner - Peripheral Vascular Disease 3678632635 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Peripheral Vascular Disease
Education
Rowan University School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beebe Physician Network Inc.Group PAC ID 5496744864, 301 clinicians

Practice addresses (Care Compare)

1600 Pennsylvania Ave
Wilmington, DE 19806-4047
Phone (302) 656-0214

18947 John Willms Hwy
Unit 210
Rehoboth Beach, DE 19971-4476
Phone (302) 645-3121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80 of 100Reported as group
Quality
62.88
Promoting interoperability
94
Improvement activities
40
Cost
75.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24
Removal of tissue475
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017079MIMDPlastic Surgery Physician
C20008811DEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the East, PA Family Medicine CurrentSince Nov 6, 2013 Accepting new patients
Beebe Physician Network, Inc. Family Medicine CurrentSince May 1, 2019 Accepting new patients
Aesthetic Plastic Surgery of Delaware, P.a. Plastic Surgery CurrentSince Oct 1, 2008 Accepting new patients
Beebe Medical Center, Inc. CurrentSince May 2, 2017 Accepting new patients
State of Delaware-Stockley CurrentSince May 1, 2019 Accepting new patients

Locations

424 Savannah Rd
Lewes, DE 19958
Phone (302) 441-1078

32550 Docs Pl
Unit 2
Millville, DE 19967
Phone (302) 539-4302

200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

18947 John J Williams Hwy
Unit 210
Rehoboth Beach, DE 19971
Phone (302) 478-7981

1600 Pennsylvania Ave
Wilmington, DE 19806
Phone (302) 439-3063

Interoperability endpoints

  • Direct secure messaging: ilonergan22711@beebehealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1174795744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PENNSYLVANIA AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064047",
            "telephone_number": "302-656-0214",
            "fax_number": "877-284-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PENNSYLVANIA AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064047",
            "telephone_number": "302-656-0214",
            "fax_number": "877-284-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONERGAN",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-24",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C20008811",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "5101017079",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "DE",
            "license": "C20008811",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C20008811",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "136323YABT",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.